67902 prior authorization | Premera Blue Cross of Washington

67902, Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 67902
Description: Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 384 Original policy

Premera Blue Cross of Washington prior authorization

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