21127 prior authorization | Anthem Blue Cross Blue Shield of California

21127, Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 21127
Description: Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)
Source: California PPO Prior Authorization List, Pg 35 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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