21110 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

21110, Application of interdental fixation device for conditions other than fracture or dislocation, includes removal, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 21110
Description: Application of interdental fixation device for conditions other than fracture or dislocation, includes removal
Source: New Hampshire Precertification List, Pg 85 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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