Anthem Blue Cross and Blue Shield New Hampshire prior authorization 63688

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 63688: Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array

Code: 63688
Description: Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array
Source: New Hampshire Precertification List, Pg 135 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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