Blue Cross and Blue Shield of Montana prior authorization E0493

Blue Cross and Blue Shield of Montana prior authorization for E0493: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply

Code: E0493
Description: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 258 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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