58145 prior authorization | Anthem Blue Cross Blue Shield of Georgia

58145, Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 58145
Description: Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach
Source: Standard Local Prior Authorization Code List, Pg 23 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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