53454 prior authorization | Anthem Blue Cross and Blue Shield Virginia

53454, Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 53454
Description: Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 22 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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