A4540 prior authorization | Anthem Blue Cross and Blue Shield Virginia

A4540, Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: A4540
Description: Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 61 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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