Q4354 prior authorization | Anthem Blue Cross Blue Shield of Georgia

Q4354, Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add- on, list separately in addition to primary procedure), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: Q4354
Description: Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add- on, list separately in addition to primary procedure)
Source: Standard Local Prior Authorization Code List, Pg 153 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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