Premera Blue Cross of Washington prior authorization 93457

Premera Blue Cross of Washington prior authorization for 93457: Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization These criteria do not imply or guarantee approval.

Code
93457
Description
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization These criteria do not imply or guarantee approval.
Source
Clinical Review by Code List PBCWA, Pg 515 Original policy

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