S2066 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

S2066, Breast reconstruction with gluteal artery perforator (GAP) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: S2066
Description: Breast reconstruction with gluteal artery perforator (GAP) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral
Source: New Hampshire Precertification List, Pg 265 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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