54411 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
54411, Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 54411
- Description
- Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
- Source
- New Hampshire Precertification List, Pg 9 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization