21247 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

21247, Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 21247
Description: Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)
Source: New Hampshire Precertification List, Pg 88 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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