19380 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

19380, Revision of reconstructed breast (eg, significant removal of tissue, re- advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 19380
Description: Revision of reconstructed breast (eg, significant removal of tissue, re- advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)
Source: New Hampshire Precertification List, Pg 83 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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