72158 prior authorization | Anthem Blue Cross Blue Shield of Georgia

72158, Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 72158
Description: Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar
Source: Standard Local Prior Authorization Code List, Pg 33 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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