0786T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0786T, Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0786T
Description: Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed
Source: New Hampshire Precertification List, Pg 72 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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