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Items and services required for prior authorization or post-procedure review include skin and tissue substitutes, electrical nerve stimulators, and knee arthroscopy for knee osteoarthritis. WISeR contains some pain medicine codes and associated anesthesia codes (listed below). However, CMS intends to include more procedures in later years.
|
Procedure Category |
CPT Codes and Associated Anesthesia Codes |
|
Electrical Nerve Stimulators |
63655 |
|
Sacral Nerve Stimulation for Urinary Incontinence State |
64561, 64581 |
|
Phrenic Nerve Stimulator |
33276, 33277 |
|
Vagus Nerve Stimulation |
64568 |
|
Induced Lesions of Nerve Tracts |
64605, 64610 |
|
Epidural Steroid Injections (ESI) for Pain Management |
62321, 62323, 64479, 64480, 64483, 64484 |
|
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) |
22510, 22511, 22512, 22513, 22514, 22515 |
|
Cervical Fusion |
22554 |
|
Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee |
29877, 29881, 64447, 29880 |
|
Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea |
64582, 42975 |
|
Incontinence Control Devices |
53445, 53451, 53452, 53440, 57288 |
|
Diagnosis and Treatment of Impotence |
54400, 54401, 54405 |
|
Skin and Tissue Substitutes |
15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278 |
CMS delayed implementation of WISeR prior authorization and pre payment review for services governed by NCD 160.24 (Deep Brain Stimulation) and NCD 150.13 (Percutaneous Image Guided Lumbar Decompression) effective April 6, 2026, until a future date announced by CMS. Source:CMS 5056 N2; 91 FR 17282.
Curated by: ASA Department of Payment and Practice Policy
Date of last update: April 13, 2026
You do not have to make a payment at this time, but you can reach out to your practice/group leader to find out when they plan to pay your dues. Email or call the ASA Support team for assistance: (630) 912-2552 or info@asahq.org.
