Blue Shield of California Promise Health Plan prior authorization 76016

Blue Shield of California Promise Health Plan prior authorization for 76016: MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examination, analysis of risk vs clinical benefit of performing MR examination, and determination of MR equipment, accessory equipment, and expertise required to perform examination, with written report

Code

76016

Description

MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examination, analysis of risk vs clinical benefit of performing MR examination, and determination of MR equipment, accessory equipment, and expertise required to perform examination, with written report

Source

Medi-Cal Prior Authorization List, Pg 5 Original policy

Blue Shield of California Promise Health Plan prior authorization