Anthem Blue Cross and Blue Shield Nevada policy
CG-MED-100 Surface Electrical Stimulation Devices for Headache and Migraine
CG-MED-100 Surface Electrical Stimulation Devices for Headache and Migraine is a public Anthem Blue Cross and Blue Shield Nevada policy (policy CG-MED-100). It lists 3 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-MED-100
- 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 |
|---|---|---|---|
| A4540 | On the list | Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm | Policies naming A4540 |
| E0735 | On the list | Non-invasive vagus nerve stimulator | Policies naming E0735 |
| E1399 | Not listed | Policies naming E1399 |
All Anthem Blue Cross and Blue Shield Nevada policies · Anthem Blue Cross and Blue Shield Nevada prior authorization CPT list