0637T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
0637T, Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 0637T
- Description
- Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s)
- Source
- New Hampshire Precertification List, Pg 66 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization