Anthem Blue Cross and Blue Shield Nevada prior authorization 77412

Anthem Blue Cross and Blue Shield Nevada prior authorization for 77412: Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (eg, 2D, 3D, or IMRT) or a single-isocenter photon therapy (eg, 3D or IMRT) with active motion m

Code: 77412
Description: Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (eg, 2D, 3D, or IMRT) or a single-isocenter photon therapy (eg, 3D or IMRT) with active motion m
Source: Nevada Prior Authorization List, Pg 85 Original policy

Anthem Blue Cross and Blue Shield Nevada prior authorization

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