C9604 prior authorization | Anthem Blue Cross and Blue Shield Virginia

C9604, Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: C9604
Description: Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 63 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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