K0745 prior authorization | Premera Blue Cross of Washington

K0745, Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: K0745
Description: Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches
Source: Clinical Review by Code List PBCWA, Pg 737 Original policy

Premera Blue Cross of Washington prior authorization

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