G6017 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
G6017, Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (e.g., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- G6017
- Description
- Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (e.g., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment
- Source
- New Hampshire Precertification List, Pg 232 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization