CPT 64635 · RFA · Veterans Affairs
RFA — Lumbar/Sacral Facet (1st level) at Veterans Affairs.
How Veterans Affairs approaches CPT 64635 (RFA — Lumbar/Sacral Facet (1st level)) for prior-authorization review: at last review on 2022-02-01, the policy covers this code with prior authorization required.
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Verification 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 Veterans Affairs policy of record for CPT 64635. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Two diagnostic medial branch blocks (CPT 64493/64494) documentation required (typically with ≥80% relief).
Source: VA/DoD Clinical Practice Guideline — Diagnosis and Treatment of Low Back Pain
See the full Veterans Affairs criteria.
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