Anthem Blue Cross and Blue Shield New Hampshire prior authorization 0275T

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 0275T: Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), single or multiple levels, unilateral or bilateral; lumbar

Code: 0275T
Description: Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), single or multiple levels, unilateral or bilateral; lumbar
Source: New Hampshire Precertification List, Pg 38 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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