Anthem Blue Cross and Blue Shield Virginia policy
Upper Extremity Myoelectric Orthoses
Upper Extremity Myoelectric Orthoses is a public Anthem Blue Cross and Blue Shield Virginia policy (policy OR-PR.00005). It lists 5 CPT or HCPCS codes, 1 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
- OR-PR.00005
- 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 |
|---|---|---|---|
| A8005 | Not listed | Policies naming A8005 | |
| A8006 | Not listed | Policies naming A8006 | |
| L3999 | Not listed | Policies naming L3999 | |
| L8701 | Not listed | Policies naming L8701 | |
| L8702 | On the list | Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessorie | Policies naming L8702 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list