Anthem Blue Cross Blue Shield of California prior authorization 21194

Anthem Blue Cross Blue Shield of California prior authorization for 21194: Mandibular/Maxillary (Orthognathic) Surgery - Reconstruction of mandibular rami, horizontal, vertical, C or L osteotomy; with bone graft

Code
21194
Description
Mandibular/Maxillary (Orthognathic) Surgery - Reconstruction of mandibular rami, horizontal, vertical, C or L osteotomy; with bone graft
Source
California PPO Prior Authorization List, Pg 36 Original policy

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