0450T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0450T, Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedure), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0450T
Description: Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedure)
Source: New Hampshire Precertification List, Pg 55 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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