Anthem Blue Cross Blue Shield of California prior authorization C7569

Anthem Blue Cross Blue Shield of California prior authorization for C7569: Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Code

C7569

Description

Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Source

California PPO Prior Authorization List, Pg 159 Original policy

Anthem Blue Cross Blue Shield of California prior authorization