G9303

Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given

Short Description: Norsn no pros info op rpt

Coverage Code: Carrier judgment

Action Code: No maintenance for this code

Date Added: January 1, 2014

Effective Date: January 1, 2015

Termination Date:

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