Anthem Blue Cross and Blue Shield New Hampshire prior authorization 15772
Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 15772: Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for primary procedure)
- Code
- 15772
- Description
- Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for primary procedure)
- Source
- New Hampshire Precertification List, Pg 3 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization