58954 prior authorization | Anthem Blue Cross Blue Shield of Georgia

58954, Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 58954
Description: Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy
Source: Standard Local Prior Authorization Code List, Pg 104 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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