51721 prior authorization | Anthem Blue Cross Blue Shield of California

51721, Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 51721
Description: Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed
Source: California PPO Prior Authorization List, Pg 103 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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