55865 prior authorization | Premera Blue Cross of Washington

55865, Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 55865
Description: Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
Source: Clinical Review by Code List PBCWA, Pg 353 Original policy

Premera Blue Cross of Washington prior authorization

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