Premera Blue Cross of Washington prior authorization 75635

Premera Blue Cross of Washington prior authorization for 75635: Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, performed, and image postprocessing

Code: 75635
Description: Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, performed, and image postprocessing
Source: Clinical Review by Code List PBCWA, Pg 412 Original policy

Premera Blue Cross of Washington prior authorization

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