Premera Blue Cross of Washington prior authorization 77387

Premera Blue Cross of Washington prior authorization for 77387: Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed These criteria do not imply or guarantee approval.

Code: 77387
Description: Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 421 Original policy

Premera Blue Cross of Washington prior authorization

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