21188 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

21188, Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 21188
Description: Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)
Source: New Hampshire Precertification List, Pg 87 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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