0633T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0633T, Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0633T
Description: Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material
Source: New Hampshire Precertification List, Pg 66 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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