Medical Policy Revision: Ablation of Peripheral Nerves to Treat Pain

Effective October 3, 2022, Horizon will change the way we consider certain professional claims based on a revision to our medical policy, Ablation of Peripheral Nerves to Treat Pain.

Claims submitted for services provided on and after October 3, 2022 to patients enrolled in Horizon commercial plans, Administrative Services Only (ASO) employer group plans, Horizon Medicare Advantage plans or Braven Health℠ Medicare Advantage plans will be processed as follows.

• Regardless of the submitted diagnosis code(s), the services represented by CPT® code 64624 will be denied as experimental/investigational, non-covered services.

CPT® is a registered mark of the American Medical Association.