0565T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0565T, Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0565T
Description: Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation
Source: New Hampshire Precertification List, Pg 62 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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