Premera Blue Cross of Washington prior authorization 55875

Premera Blue Cross of Washington prior authorization for 55875: Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy

Code
55875
Description
Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy
Source
Clinical Review by Code List PBCWA, Pg 354 Original policy

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