77771 prior authorization | Blue Cross and Blue Shield of Montana
77771, Remote Afterloading High Dose Rate Radionuclide Interstitial Or Intracavitary Brachytherapy Includes Basic Dosimetry When Performed; 2-12 Channels, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.
- Code
- 77771
- Description
- Remote Afterloading High Dose Rate Radionuclide Interstitial Or Intracavitary Brachytherapy Includes Basic Dosimetry When Performed; 2-12 Channels
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 90 Original policy