Premera Blue Cross of Washington prior authorization 74175

Premera Blue Cross of Washington prior authorization for 74175: Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing These criteria do not imply or guarantee approval.

Code: 74175
Description: Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 407 Original policy

Premera Blue Cross of Washington prior authorization

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