77318 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
77318, Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 77318
- Description
- Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)
- Source
- New Hampshire Precertification List, Pg 150 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization