Anthem Blue Cross and Blue Shield Virginia policy
MED.00004 Noninvasive Imaging Technologies for the Evaluation of Skin Lesions
MED.00004 Noninvasive Imaging Technologies for the Evaluation of Skin Lesions is a public Anthem Blue Cross and Blue Shield Virginia policy (policy MED.00004). It lists 12 CPT or HCPCS codes, 10 of them on the Anthem Blue Cross and Blue Shield Virginia prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- MED.00004
- 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 Virginia prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield Virginia policies |
|---|---|---|---|
| 0658T | On the list | Electrical impedance spectroscopy of 1 or more skin lesions for automa | Policies naming 0658T |
| 0700T | On the list | Molecular fluorescent imaging of suspicious nevus; first lesion | Policies naming 0700T |
| 0701T | On the list | Molecular fluorescent imaging of suspicious nevus; each additional lesion (List separately in addition to code for primary procedure) | Policies naming 0701T |
| 1020T | Not listed | Policies naming 1020T | |
| 96904 | On the list | Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history o | Policies naming 96904 |
| 96931 | On the list | Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion | Policies naming 96931 |
| 96932 | On the list | Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion | Policies naming 96932 |
| 96933 | On the list | Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion | Policies naming 96933 |
| 96934 | On the list | Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (List separately i | Policies naming 96934 |
| 96935 | On the list | Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (List separately in addition to code for pr | Policies naming 96935 |
| 96936 | On the list | Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (List separately in addition to cod | Policies naming 96936 |
| 96999 | Not listed | Policies naming 96999 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list