1094T prior authorization | Anthem Blue Cross Blue Shield of California

1094T, Implantation of acellular scaffold (eg, hyaluronan), knee, single implant; each additional acellular scaffold implantation, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 1094T
Description: Implantation of acellular scaffold (eg, hyaluronan), knee, single implant; each additional acellular scaffold implantation
Source: California PPO Prior Authorization List, Pg 19 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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