21159 prior authorization | Anthem Blue Cross and Blue Shield Virginia

21159, Reconstruction Midface, Lefort Iii, (Extra/Intracranial), W/Bone Grafts, W/O Lefort I, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 21159
Description: Reconstruction Midface, Lefort Iii, (Extra/Intracranial), W/Bone Grafts, W/O Lefort I
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 13 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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