0718T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
0718T, Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 0718T
- Description
- Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral
- Source
- New Hampshire Precertification List, Pg 69 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization