Anthem Blue Cross and Blue Shield Virginia prior authorization G0460

Anthem Blue Cross and Blue Shield Virginia prior authorization for G0460: Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all ot

Code: G0460
Description: Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all ot
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 66 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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