Interventional pain management services for *64451 and *64625 require authorization starting May 1 for all Blue Cross and BCN members

For dates of service on or after May 1, 2020, interventional pain management services associated with procedure codes *64451 and *64625 require authorization by eviCore healthcare.

This applies to all Blue Cross and Blue Care Network members with plans subject to eviCore healthcare authorization requirements:

• Blue Cross' PPO
• Medicare Plus Blue^SM PPO
• BCN HMO^SM
• BCN Advantage^SM

We've updated the document titled Procedures that require clinical review by eviCore healthcare (PDF) to reflect this new requirement.

How to submit authorization requests

Submit authorization requests to eviCore in one of these ways:

• Preferred: Use evicore's provider portal at www.evicore.com.**
• Alternative: Call eviCore at 1-855-774-1317.
• Alternative: Fax to eviCore at 1-800-540-2406.

Additional information

For more information, refer to the document titled eviCore Management Program: Frequently Asked Questions (PDF).

You can find this document and other resources on this website:

• The BCN eviCore-Managed Procedures webpage
• The Blue Cross eviCore-Managed Procedures webpage

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2019 American Medical Association. All rights reserved.

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