58200 prior authorization | Anthem Blue Cross and Blue Shield Virginia

58200, Total Abdominal Hysterectomy, W/Partial Vaginect, W/Pelvic Node Sample, W/Wo Rem Tubes/Ovaries, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 58200
Description: Total Abdominal Hysterectomy, W/Partial Vaginect, W/Pelvic Node Sample, W/Wo Rem Tubes/Ovaries
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 23 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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