CPT 64479 · Epidural · Premera Blue Cross
TFESI — Cervical/Thoracic (1st level) at Premera Blue Cross.
How Premera Blue Cross approaches CPT 64479 (TFESI — Cervical/Thoracic (1st level)) for prior-authorization review: at last review on 2022-10-10, the policy covers this code with prior authorization required.
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2.01.537Criteria summary
High-level themes from the Premera Blue Cross policy of record for CPT 64479. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Premera Medical Policy 2.01.537 — Trigger Point and Transforaminal Epidural Injections
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