Anthem Blue Cross and Blue Shield New Hampshire prior authorization 77317

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 77317: Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)

Code: 77317
Description: Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)
Source: New Hampshire Precertification List, Pg 150 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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