61736 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

61736, Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 61736
Description: Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion
Source: New Hampshire Precertification List, Pg 126 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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