Anthem Blue Cross and Blue Shield New Hampshire prior authorization 77318

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 77318: Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)

Code: 77318
Description: Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 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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