Anthem Blue Cross and Blue Shield New Hampshire prior authorization G0460

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for G0460: Autologous platelet rich plasma (PRP) or other blood-derived product for nondiabetic chronic wounds/ulcers (includes, as applicable: administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)

Code: G0460
Description: Autologous platelet rich plasma (PRP) or other blood-derived product for nondiabetic chronic wounds/ulcers (includes, as applicable: administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)
Source: New Hampshire Precertification List, Pg 230 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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