Anthem Blue Cross Blue Shield of Colorado prior authorization C5274

Anthem Blue Cross Blue Shield of Colorado prior authorization for C5274: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area

Code: C5274
Description: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area
Source: Colorado Prior Authorization List, Pg 146 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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