76873 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

76873, Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 76873
Description: Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)
Source: New Hampshire Precertification List, Pg 149 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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