L8688 prior authorization | Anthem Blue Cross and Blue Shield Virginia
L8688, Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- L8688
- Description
- Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 74 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization