21188 prior authorization | Anthem Blue Cross and Blue Shield Virginia

21188, Reconstruction, Midface, Osteotomies (Non-Lefort Type), W/Grafts, W/Obtaining Autografts, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 21188
Description: Reconstruction, Midface, Osteotomies (Non-Lefort Type), W/Grafts, W/Obtaining Autografts
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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