Anthem Blue Cross and Blue Shield Nevada policy
CG-DME-53 Biomechanical Footwear Therapy
CG-DME-53 Biomechanical Footwear Therapy is a public Anthem Blue Cross and Blue Shield Nevada policy (policy CG-DME-53). It lists 7 CPT or HCPCS codes, 2 of them on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-DME-53
- Line of business
- Commercial
- Source
- www.anthem.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Prior authorization status is from the Anthem Blue Cross and Blue Shield Nevada prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield Nevada policies |
|---|---|---|---|
| 96000 | Not listed | Policies naming 96000 | |
| 97760 | On the list | Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s | Policies naming 97760 |
| 97763 | On the list | Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes | Policies naming 97763 |
| 97799 | Not listed | Policies naming 97799 | |
| L2999 | Not listed | Policies naming L2999 | |
| L3649 | Not listed | Policies naming L3649 | |
| T1999 | Not listed | Policies naming T1999 |
All Anthem Blue Cross and Blue Shield Nevada policies · Anthem Blue Cross and Blue Shield Nevada prior authorization CPT list