77317 prior authorization | Anthem Blue Cross Blue Shield of Colorado

77317, Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(, is on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage or referral decision.

Code: 77317
Description: Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(
Source: Colorado Prior Authorization List, Pg 92 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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