Blue Cross and Blue Shield of Montana prior authorization B4149
Blue Cross and Blue Shield of Montana prior authorization for B4149: Enteral Formula Manufactured Blenderized Natural Foods With Intact Nutrients Includes Proteins Fats Carbohydrates Vitamins And Minerals May Include Fiber Administered Through An Enteral Feeding Tube 100 Calories = 1 Unit
- Code
- B4149
- Description
- Enteral Formula Manufactured Blenderized Natural Foods With Intact Nutrients Includes Proteins Fats Carbohydrates Vitamins And Minerals May Include Fiber Administered Through An Enteral Feeding Tube 100 Calories = 1 Unit
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 247 Original policy