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64629 - Basivertebral nerve ablation – destruction CPT , All

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Procedure / ServiceBasivertebral nerve ablation – destruction CPT , All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Rectal control system for vaginal insertion (long term use) A4563 All Bronchoscopy with microwave ablation and full image guided navigation bundle C9751 All Basivertebral nerve ablation – destruction CPT 64628, 64629 All EoE biomarker ELISA (eotaxin 3, PRG2) with algorithm 0095U All Hereditary colon cancer panel with mRNA analytics (15+ genes) 0101U All

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  • Submit clinical notes if requested by the plan
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