21255 prior authorization | Anthem Blue Cross Blue Shield of California

21255, Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 21255
Description: Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (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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