0636T prior authorization | Anthem Blue Cross Blue Shield of Georgia

0636T, Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 0636T
Description: Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s)
Source: Standard Local Prior Authorization Code List, Pg 81 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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