0216T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
0216T, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 0216T
- Description
- Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level
- Source
- New Hampshire Precertification List, Pg 30 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization