77771 prior authorization | Anthem Blue Cross Blue Shield of Colorado

77771, Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels, is on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage or referral decision.

Code: 77771
Description: Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels
Source: Colorado Prior Authorization List, Pg 93 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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