19296 prior authorization | Premera Blue Cross of Washington

19296, Placement of radiotherapy after loading balloon catheter into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 19296
Description: Placement of radiotherapy after loading balloon catheter into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy
Source: Clinical Review by Code List PBCWA, Pg 240 Original policy

Premera Blue Cross of Washington prior authorization

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