CPT 64628 · BVN Ablation · BCBS Alabama
Intracept — Basivertebral Nerve Ablation (1st level) at BCBS Alabama.
How BCBS Alabama approaches CPT 64628 (Intracept — Basivertebral Nerve Ablation (1st level)) for prior-authorization review: at last review on 2025-01-01, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-01-01
Policy number
BCBS-AL-BVN-deferCriteria summary
High-level themes from the BCBS Alabama policy of record for CPT 64628. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: BCBS Alabama Medical Policy (BVN ablation — specific MP not located)
See the full BCBS Alabama criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →