0718T prior authorization | Anthem Blue Cross and Blue Shield Virginia
0718T: Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilate. Imported Anthem Blue Cross and Blue Shield Virginia PPO source reference; confirm plan-specific review requirements in the original document. Not a coverage or referral decision.
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Code
0718T
Description
Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilate
Source
Virginia PPO standard precertification/prior authorization requirements, Pg 10 Original policy
Anthem Blue Cross and Blue Shield Virginia policies that name 0718T
The payer's medical and payment policies that list 0718T, those listing the fewest codes first. A policy can also list a code it excludes.
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