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: