54405 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

54405, Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 54405
Description: Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir
Source: New Hampshire Precertification List, Pg 123 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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