G0460 prior authorization | Anthem Blue Cross Blue Shield of Colorado

G0460, Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all ot, is on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage or referral decision.

Code: G0460
Description: Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all ot
Source: Colorado Prior Authorization List, Pg 153 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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