Anthem Blue Cross and Blue Shield New Hampshire prior authorization 21141
Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 21141: Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft
- Code
- 21141
- Description
- Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft
- Source
- New Hampshire Precertification List, Pg 86 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization