G0339 prior authorization | Premera Blue Cross of Washington

G0339, Image guided robotic linear accelerator- based stereotactic radiosurgery, complete course of therapy in one session, or first session of fractionated treatment, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: G0339
Description: Image guided robotic linear accelerator- based stereotactic radiosurgery, complete course of therapy in one session, or first session of fractionated treatment
Source: Clinical Review by Code List PBCWA, Pg 685 Original policy

Premera Blue Cross of Washington prior authorization

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