0102T prior authorization | Anthem Blue Cross and Blue Shield Virginia

0102T, Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 0102T
Description: Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 3 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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