E0485 prior authorization | Anthem Blue Cross and Blue Shield Virginia

E0485, Oral device/appliance used to reduce upper airway collapsibility, adjustable or non- adjustable, prefabricated, includes, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: E0485
Description: Oral device/appliance used to reduce upper airway collapsibility, adjustable or non- adjustable, prefabricated, includes
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 64 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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