Premera Blue Cross of Washington prior authorization G0330

Premera Blue Cross of Washington prior authorization for G0330: Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room

Code: G0330
Description: Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room
Source: Clinical Review by Code List PBCWA, Pg 685 Original policy

Premera Blue Cross of Washington prior authorization

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