Q4351 prior authorization | Anthem Blue Cross and Blue Shield Virginia
Q4351, Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure), is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- Q4351
- Description
- Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 79 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization