Anthem Blue Cross and Blue Shield New Hampshire prior authorization 15771

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 15771: Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate

Code: 15771
Description: Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate
Source: New Hampshire Precertification List, Pg 80 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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