0966T prior authorization | Anthem Blue Cross Blue Shield of California

0966T, Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 0966T
Description: Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism
Source: California PPO Prior Authorization List, Pg 145 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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