0417T prior authorization | Anthem Blue Cross Blue Shield of California

0417T, Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation system, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 0417T
Description: Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation system
Source: California PPO Prior Authorization List, Pg 52 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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