Anthem Blue Cross and Blue Shield New Hampshire prior authorization 0773T

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 0773T: Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural dissociation supports; initial 15 minutes of intraservice time, patient age 5 years or older

Code

0773T

Description

Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural dissociation supports; initial 15 minutes of intraservice time, patient age 5 years or older

Source

New Hampshire Precertification List, Pg 71 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization