0474T prior authorization | Anthem Blue Cross Blue Shield of California

0474T, Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space; each additional device [XEN Gel Stent], is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 0474T
Description: Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space; each additional device [XEN Gel Stent]
Source: California PPO Prior Authorization List, Pg 52 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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