Anthem Blue Cross and Blue Shield Virginia prior authorization 75573

Anthem Blue Cross and Blue Shield Virginia prior authorization for 75573: Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postproce

Code: 75573
Description: Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postproce
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 29 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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