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Q4242 prior authorization | Anthem Blue Cross Blue Shield of Colorado

Q4242: AmnioCyte Plus, per 0.5 cc. Imported Anthem Blue Cross Blue Shield of Colorado source reference; confirm plan-specific review requirements in the original document. Not a coverage or referral decision.

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Code
Q4242
Description
AmnioCyte Plus, per 0.5 cc
Source
Colorado Prior Authorization List, Pg 170 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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