Anthem Blue Cross and Blue Shield New Hampshire prior authorization 75574

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 75574: Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)

Code: 75574
Description: Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)
Source: New Hampshire Precertification List, Pg 148 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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