S8030 prior authorization | Anthem Blue Cross and Blue Shield Virginia

S8030: Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy. Imported Anthem Blue Cross and Blue Shield Virginia HMO/EPO source reference; confirm plan-specific review requirements in the original document. Not a coverage or referral decision.

Code

S8030

Description

Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy

Source

Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 81 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization