Anthem Blue Cross and Blue Shield New Hampshire prior authorization E0491

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for E0491: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply

Code: E0491
Description: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply
Source: New Hampshire Precertification List, Pg 224 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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