77423 prior authorization | Anthem Blue Cross Blue Shield of California
77423, High energy neutron radiation treatment delivery; 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.
- Code
- 77423
- Description
- High energy neutron radiation treatment delivery; 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)
- Source
- California PPO Prior Authorization List, Pg 45 Original policy
Anthem Blue Cross Blue Shield of California prior authorization