Anthem Blue Cross and Blue Shield New Hampshire prior authorization 63057
Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 63057: Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately in addition to code for primary procedure)
- Code
- 63057
- Description
- Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately in addition to code for primary procedure)
- Source
- New Hampshire Precertification List, Pg 131 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization