15273 prior authorization | Anthem Blue Cross and Blue Shield Virginia
15273, Application Of Skin Substitute Graft To Trunk, Arms, Legs, Total Wound Surface Area Greater Than Or Equal To 100 Sq Cm; First 100 Sq Cm Wound Surface Area, Or 1% Of Body Area, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- 15273
- Description
- Application Of Skin Substitute Graft To Trunk, Arms, Legs, Total Wound Surface Area Greater Than Or Equal To 100 Sq Cm; First 100 Sq Cm Wound Surface Area, Or 1% Of Body Area
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 11 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization