77318 prior authorization | Anthem Blue Cross and Blue Shield Virginia

77318, Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s), is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 77318
Description: Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 29 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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