Anthem Blue Cross Blue Shield of California prior authorization 1095T
Anthem Blue Cross Blue Shield of California prior authorization for 1095T: Harvesting and processing of autologous bone marrow aspirate concentrate (BMAC), with application onto scaffold or injection into anatomical recipient site (eg, subchondral bone, joint space, chondral lesion), including imaging guidance, when performed, for therapeutic musculoskeletal treatment, excluding spinal procedures
Code
1095T
Description
Harvesting and processing of autologous bone marrow aspirate concentrate (BMAC), with application onto scaffold or injection into anatomical recipient site (eg, subchondral bone, joint space, chondral lesion), including imaging guidance, when performed, for therapeutic musculoskeletal treatment, excluding spinal procedures
Source
California PPO Prior Authorization List, Pg 19 Original policy
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