K0855 prior authorization | Anthem Blue Cross and Blue Shield Virginia
K0855, POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- K0855
- Description
- POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 73 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization