Anthem Blue Cross Blue Shield of Georgia prior authorization 21145

Anthem Blue Cross Blue Shield of Georgia prior authorization for 21145: Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)

Code: 21145
Description: Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)
Source: Standard Local Prior Authorization Code List, Pg 96 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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