55874 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

55874, Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 55874
Description: Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed
Source: New Hampshire Precertification List, Pg 124 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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