64415 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
64415, Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 64415
- Description
- Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed
- Source
- New Hampshire Precertification List, Pg 135 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization