75635 prior authorization | Blue Cross and Blue Shield of Montana

75635, Computed Tomographic Angiography Abdominal Aorta And Bilateral Iliofemoral Lower Extremity Runoff With Contrast Material(S) Including Noncontrast Images If Performed And Image Postprocessing, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 75635
Description: Computed Tomographic Angiography Abdominal Aorta And Bilateral Iliofemoral Lower Extremity Runoff With Contrast Material(S) Including Noncontrast Images If Performed And Image Postprocessing
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 84 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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