77768 prior authorization | Anthem Blue Cross and Blue Shield Nevada

77768, Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or mu, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.

Code: 77768
Description: Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or mu
Source: Nevada Prior Authorization List, Pg 86 Original policy

Anthem Blue Cross and Blue Shield Nevada prior authorization

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