21146 prior authorization | Anthem Blue Cross and Blue Shield Nevada
21146, Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.
- Code
- 21146
- Description
- Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining
- Source
- Nevada Prior Authorization List, Pg 13 Original policy
Anthem Blue Cross and Blue Shield Nevada prior authorization