54417 prior authorization | Anthem Blue Cross and Blue Shield Virginia

54417, Removal & Replace, Non-Inflatable/Inflatable Penile Prosthesis Infect, W/Irrig & Debride, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 54417
Description: Removal & Replace, Non-Inflatable/Inflatable Penile Prosthesis Infect, W/Irrig & Debride
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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