0655T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0655T, Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR- fused images or other enhanced ultrasound imaging, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0655T
Description: Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR- fused images or other enhanced ultrasound imaging
Source: New Hampshire Precertification List, Pg 67 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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