77770 prior authorization | Anthem Blue Cross Blue Shield of California

77770, Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel [when specified as coronary intravascular brachytherapy], is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 77770
Description: Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel [when specified as coronary intravascular brachytherapy]
Source: California PPO Prior Authorization List, Pg 121 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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