0627T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0627T, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0627T
Description: Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level
Source: New Hampshire Precertification List, Pg 65 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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