21179 prior authorization | Anthem Blue Cross Blue Shield of Georgia

21179, Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 21179
Description: Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)
Source: Standard Local Prior Authorization Code List, Pg 96 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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