B4180 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

B4180, Parenteral nutrition solution: carbohydrates (dextrose), greater than 50% (500 ml = 1 unit), home mix, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: B4180
Description: Parenteral nutrition solution: carbohydrates (dextrose), greater than 50% (500 ml = 1 unit), home mix
Source: New Hampshire Precertification List, Pg 209 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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