Anthem Blue Cross Blue Shield of California prior authorization 93641

Anthem Blue Cross Blue Shield of California prior authorization for 93641: Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator

Code

93641

Description

Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator

Source

California PPO Prior Authorization List, Pg 50 Original policy

Anthem Blue Cross Blue Shield of California prior authorization