Anthem Blue Cross and Blue Shield New Hampshire prior authorization 0745T

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 0745T: Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, CT, MRI, or myocardial perfusion scan) and electrical data (eg, 12-lead ECG data), and identification of areas of avoidance

Code: 0745T
Description: Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, CT, MRI, or myocardial perfusion scan) and electrical data (eg, 12-lead ECG data), and identification of areas of avoidance
Source: New Hampshire Precertification List, Pg 70 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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