Anthem Blue Cross and Blue Shield New Hampshire prior authorization 77373
Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 77373: Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
- Code
- 77373
- Description
- Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
- Source
- New Hampshire Precertification List, Pg 150 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization