Anthem Blue Cross Blue Shield of California prior authorization 37241

Anthem Blue Cross Blue Shield of California prior authorization for 37241: Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (e.g., congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles) [when specified as coil embolization for varicose vein diagnoses] or [as a treatment for pelvic congestion syndrome (PCS), and percutaneous testicular vein embolization for varicocel]

Code

37241

Description

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (e.g., congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles) [when specified as coil embolization for varicose vein diagnoses] or [as a treatment for pelvic congestion syndrome (PCS), and percutaneous testicular vein embolization for varicocel]

Source

California PPO Prior Authorization List, Pg 96 Original policy

Anthem Blue Cross Blue Shield of California prior authorization