C5271 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

C5271, Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: C5271
Description: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
Source: New Hampshire Precertification List, Pg 213 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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