72194 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

72194, Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 72194
Description: Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections
Source: New Hampshire Precertification List, Pg 145 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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