Anthem Blue Cross Blue Shield of Georgia prior authorization Q4364

Anthem Blue Cross Blue Shield of Georgia prior authorization for Q4364: Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)

Code: Q4364
Description: Amnio burgeon xplus membrane and xplus hydromembrane, 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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