K0858 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

K0858, Power wheelchair, group 3 heavy-duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: K0858
Description: Power wheelchair, group 3 heavy-duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
Source: New Hampshire Precertification List, Pg 250 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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