77318 prior authorization | Blue Cross and Blue Shield of Montana

77318, Brachytherapy Isodose Plan; Complex (Calculation[S] Made From Over 10 Sources Or Remote Afterloading Brachytherapy Over 12 Channels) Includes Basic Dosimetry Calculation(S), is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 77318
Description: Brachytherapy Isodose Plan; Complex (Calculation[S] Made From Over 10 Sources Or Remote Afterloading Brachytherapy Over 12 Channels) Includes Basic Dosimetry Calculation(S)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 86 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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