58545 prior authorization | Anthem Blue Cross and Blue Shield Virginia

58545, Laparoscopy, Surg, Myomectomy; 1-4 Intramural Myomas, Total Wt 250 Gms, &/Or Remove Surface Myomas, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 58545
Description: Laparoscopy, Surg, Myomectomy; 1-4 Intramural Myomas, Total Wt 250 Gms, &/Or Remove Surface Myomas
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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