74712 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

74712, Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single of first gestation, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 74712
Description: Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single of first gestation
Source: New Hampshire Precertification List, Pg 148 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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