Anthem Blue Cross Blue Shield of Georgia prior authorization Q4354

Anthem Blue Cross Blue Shield of Georgia prior authorization for Q4354: Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add- on, list separately in addition to primary procedure)

Code: Q4354
Description: Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add- on, list separately in addition to primary procedure)
Source: Standard Local Prior Authorization Code List, Pg 153 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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