Blue Cross and Blue Shield of Montana prior authorization B4193
Blue Cross and Blue Shield of Montana prior authorization for B4193: Parenteral Nutrition Solution; Compounded Amino Acid And Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Any Strength 52 To 73 Grams Of Protein - Premix
- Code
- B4193
- Description
- Parenteral Nutrition Solution; Compounded Amino Acid And Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Any Strength 52 To 73 Grams Of Protein - Premix
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 251 Original policy