79403 prior authorization | Anthem Blue Cross Blue Shield of California

79403, Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion [when specified as injection of yttrium Y-90 ibritumomab tiuxetan (Zevalin)], is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 79403
Description: Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion [when specified as injection of yttrium Y-90 ibritumomab tiuxetan (Zevalin)]
Source: California PPO Prior Authorization List, Pg 123 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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