77373 prior authorization | Anthem Blue Cross Blue Shield of Georgia
77373, Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.
- Code
- 77373
- Description
- Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
- Source
- Standard Local Prior Authorization Code List, Pg 37 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization