Anthem Blue Cross Blue Shield of California prior authorization 77373

Anthem Blue Cross Blue Shield of California prior authorization for 77373: Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions

Code: 77373
Description: Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
Source: California PPO Prior Authorization List, Pg 120 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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