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New Preauthorization Requirements Starting Aug. 15, 2025
Date Posted: 06/04/2025
The following codes are being added to our preauthorization list effective Aug. 15, 2025.
Codes Added to Preauthorization List Starting Aug. 15, 2025
CPT/HCPCS Code |
CPT Code Description |
|---|---|
64628 |
Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral |
64629 |
Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) |
The following codes were removed from our preauthorization list effective Jan. 1, 2025.
Codes Removed From Preauthorization List Starting Jan. 1, 2025
| CPT/HCPCS Code | CPT Code Description |
|---|---|
E0737 |
Transcutaneous tibial nerve stimulator, controlled by phone application |
A4545 |
Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month |