Anthem Blue Cross and Blue Shield New Hampshire prior authorization C5272

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for C5272: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)

Code: C5272
Description: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
Source: New Hampshire Precertification List, Pg 213 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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