96904 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

96904, Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 96904
Description: Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma
Source: New Hampshire Precertification List, Pg 197 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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