Blue Cross and Blue Shield of Montana prior authorization 77435

Blue Cross and Blue Shield of Montana prior authorization for 77435: Stereotactic Body Radiation Therapy Treatment Management Per Treatment Course To 1 Or More Lesions Including Image Guidance Entire Course Not To Exceed 5 Fractions

Code: 77435
Description: Stereotactic Body Radiation Therapy Treatment Management Per Treatment Course To 1 Or More Lesions Including Image Guidance Entire Course Not To Exceed 5 Fractions
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 88 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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