Anthem Blue Cross Blue Shield of California prior authorization 92930

Anthem Blue Cross Blue Shield of California prior authorization for 92930: Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring angioplasty and/or stenting in both the main artery and the side branch

Code

92930

Description

Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring angioplasty and/or stenting in both the main artery and the side branch

Source

California PPO Prior Authorization List, Pg 136 Original policy

Anthem Blue Cross Blue Shield of California prior authorization