Premera Blue Cross of Washington prior authorization 19380

Premera Blue Cross of Washington prior authorization for 19380: Revision of reconstructed breast (eg, significant removal of tissue, re- advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)

Code: 19380
Description: Revision of reconstructed breast (eg, significant removal of tissue, re- advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)
Source: Clinical Review by Code List PBCWA, Pg 242 Original policy

Premera Blue Cross of Washington prior authorization

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