58267 prior authorization | Anthem Blue Cross and Blue Shield Virginia

58267, Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall- Marchetti-Krantz type, Pereyra typ, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 58267
Description: Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall- Marchetti-Krantz type, Pereyra typ
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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