55874 prior authorization | Anthem Blue Cross and Blue Shield Nevada
55874, Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.
- Code
- 55874
- Description
- Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed
- Source
- Nevada Prior Authorization List, Pg 57 Original policy
Anthem Blue Cross and Blue Shield Nevada prior authorization