19380 prior authorization | Anthem Blue Cross and Blue Shield Virginia
19380, Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re- inset of flaps in autologous reconstruction or significant capsular revision comb, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- 19380
- Description
- Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re- inset of flaps in autologous reconstruction or significant capsular revision comb
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 12 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization