Anthem Blue Cross and Blue Shield Virginia prior authorization 21147

Anthem Blue Cross and Blue Shield Virginia prior authorization for 21147: Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes o

Code: 21147
Description: Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes o
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 12 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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