C9767 prior authorization | Anthem Blue Cross and Blue Shield Virginia

C9767, Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: C9767
Description: Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s)
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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