Q4363 prior authorization | Anthem Blue Cross Blue Shield of Georgia

Q4363, Amnio burgeon membrane and hydromembrane, 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: Q4363
Description: Amnio burgeon membrane and hydromembrane, 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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