90381 prior authorization | Anthem Blue Cross and Blue Shield Virginia

90381, Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 90381
Description: Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 57 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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