Anthem Blue Cross and Blue Shield New Hampshire prior authorization 0494T

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 0494T: Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservation of the allograft prior to implantation, when performed

Code
0494T
Description
Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservation of the allograft prior to implantation, when performed
Source
New Hampshire Precertification List, Pg 57 Original policy

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