Blue Cross and Blue Shield of Montana prior authorization 54417

Blue Cross and Blue Shield of Montana prior authorization for 54417: Removal and replacement of non- inflatable (semi-rigid) or inflatable (self- contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue

Code: 54417
Description: Removal and replacement of non- inflatable (semi-rigid) or inflatable (self- contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 47 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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