58571 prior authorization | Anthem Blue Cross Blue Shield of Georgia

58571, Laparoscopy, surgical, with total hysterectomy, for uterus 250g or less;with removal of tube(s) and/or ovary (s), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 58571
Description: Laparoscopy, surgical, with total hysterectomy, for uterus 250g or less;with removal of tube(s) and/or ovary (s)
Source: Standard Local Prior Authorization Code List, Pg 104 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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