E0493 prior authorization | Blue Cross and Blue Shield of Montana
E0493, Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.
- Code
- E0493
- Description
- Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 258 Original policy