21179 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

21179, Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 21179
Description: Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)
Source: New Hampshire Precertification List, Pg 87 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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