21256 prior authorization | Anthem Blue Cross Blue Shield of Georgia

21256, Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 21256
Description: Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)
Source: Standard Local Prior Authorization Code List, Pg 97 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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