E0658 prior authorization | Anthem Blue Cross and Blue Shield Virginia

E0658, Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: E0658
Description: Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest
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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