Blue Cross and Blue Shield of Montana prior authorization L5857
Blue Cross and Blue Shield of Montana prior authorization for L5857: Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type
- Code
- L5857
- Description
- Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 274 Original policy