21127 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

21127, Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 21127
Description: Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)
Source: New Hampshire Precertification List, Pg 86 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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