S4011 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

S4011, In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: S4011
Description: In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development
Source: New Hampshire Precertification List, Pg 267 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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