92928 prior authorization | Premera Blue Cross of Washington

92928, Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments 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: 92928
Description: Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 508 Original policy

Premera Blue Cross of Washington prior authorization

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