77373 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

77373, Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 77373
Description: Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
Source: New Hampshire Precertification List, Pg 150 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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