Blue Cross and Blue Shield of Montana prior authorization 74713

Blue Cross and Blue Shield of Montana prior authorization for 74713: Magnetic Resonance (Eg Proton) Imaging Fetal Including Placental And Maternal Pelvic Imaging When Performed; Each Additional Gestation (List Separately In Addition To Code For Primary Procedure)

Code: 74713
Description: Magnetic Resonance (Eg Proton) Imaging Fetal Including Placental And Maternal Pelvic Imaging When Performed; Each Additional Gestation (List Separately In Addition To Code For Primary Procedure)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 84 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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