Anthem Blue Cross and Blue Shield New Hampshire prior authorization S2068

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for S2068: Breast reconstruction with deep inferior epigastric perforator (DIEP) flap or superficial inferior epigastric artery (SIEA) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral

Code: S2068
Description: Breast reconstruction with deep inferior epigastric perforator (DIEP) flap or superficial inferior epigastric artery (SIEA) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral
Source: New Hampshire Precertification List, Pg 265 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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