E0491 prior authorization | Anthem Blue Cross and Blue Shield Virginia

E0491, Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hard, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: E0491
Description: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hard
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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