1058T prior authorization | Anthem Blue Cross Blue Shield of California

1058T, Revision of implanted subcutaneous unilateral supraorbital and occipital neurostimulator system, including all interrogation, programming, and imaging guidance, when performed, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 1058T
Description: Revision of implanted subcutaneous unilateral supraorbital and occipital neurostimulator system, including all interrogation, programming, and imaging guidance, when performed
Source: California PPO Prior Authorization List, Pg 18 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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