Anthem Blue Cross and Blue Shield New Hampshire prior authorization 78430

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 78430: Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan

Code: 78430
Description: Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan
Source: New Hampshire Precertification List, Pg 152 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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