0072T prior authorization | Blue Cross and Blue Shield of Montana

0072T, Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to 200 cc of tissue, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 0072T
Description: Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to 200 cc of tissue
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 171 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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