Anthem Blue Cross and Blue Shield New Hampshire prior authorization C5271

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for C5271: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

Code: C5271
Description: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
Source: New Hampshire Precertification List, Pg 213 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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