CPT 64635 · RFA · Regence BlueShield
RFA — Lumbar/Sacral Facet (1st level) at Regence BlueShield.
How Regence BlueShield approaches CPT 64635 (RFA — Lumbar/Sacral Facet (1st level)) for prior-authorization review: at last review on Date not on file, the policy covers this code with prior authorization required.
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TBDVerification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Regence BlueShield policy of record for CPT 64635. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Diagnostic MBB documentation required (typically with ≥80% relief).
See the full Regence BlueShield criteria.
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