K0857 prior authorization | Anthem Blue Cross and Blue Shield Virginia

K0857, POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: K0857
Description: POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 73 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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