0201T prior authorization | Anthem Blue Cross Blue Shield of Georgia

0201T, Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 0201T
Description: Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles
Source: Standard Local Prior Authorization Code List, Pg 68 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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