21110 prior authorization | Anthem Blue Cross Blue Shield of California

21110, Application of interdental fixation device for conditions other than fracture or dislocation, includes removal, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 21110
Description: Application of interdental fixation device for conditions other than fracture or dislocation, includes removal
Source: California PPO Prior Authorization List, Pg 81 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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