61715 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

61715, Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 61715
Description: Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed
Source: New Hampshire Precertification List, Pg 125 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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