77317 prior authorization | Anthem Blue Cross and Blue Shield Nevada
77317, Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.
- Code
- 77317
- Description
- Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(
- Source
- Nevada Prior Authorization List, Pg 84 Original policy
Anthem Blue Cross and Blue Shield Nevada prior authorization