A4555 prior authorization | Premera Blue Cross of Washington

A4555, Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only 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: A4555
Description: Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 544 Original policy

Premera Blue Cross of Washington prior authorization

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