Anthem Blue Cross and Blue Shield Nevada prior authorization code reference, page 87

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Source code lookup

Each row links an imported source code to its service or category label. Check the original document for the complete plan scope, review type and qualifications.

Source code index

Imported source codes and labels; verify the complete review requirements in the original document
Code	Description	Source
V5298	Hearing Aid, Not Otherwise Classified	Nevada Prior Authorization List, Pg 171 Original policy
V5362	Speech Screening	Nevada Prior Authorization List, Pg 171 Original policy
V5363	Language Screening	Nevada Prior Authorization List, Pg 171 Original policy
V5364	Dysphagia Screening	Nevada Prior Authorization List, Pg 171 Original policy

Sources

Nevada Prior Authorization List

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