21255 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

21255, Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 21255
Description: Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)
Source: New Hampshire Precertification List, Pg 88 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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