K0869 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

K0869, Power wheelchair, group 4 standard, captain's chair, patient weight capacity up to and including 300 pounds, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: K0869
Description: Power wheelchair, group 4 standard, captain's chair, patient weight capacity up to and including 300 pounds
Source: New Hampshire Precertification List, Pg 251 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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