0863T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0863T, Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0863T
Description: Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only
Source: New Hampshire Precertification List, Pg 75 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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