21188 prior authorization | Anthem Blue Cross Blue Shield of California

21188, Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 21188
Description: Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)
Source: California PPO Prior Authorization List, Pg 3 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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