55874 prior authorization | Anthem Blue Cross Blue Shield of Georgia
55874, Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.
- Code
- 55874
- Description
- Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed
- Source
- Standard Local Prior Authorization Code List, Pg 23 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization