Anthem Blue Cross Blue Shield of California policy
CG-DME-53 Biomechanical Footwear Therapy
CG-DME-53 Biomechanical Footwear Therapy is a public Anthem Blue Cross Blue Shield of California policy (policy CG-DME-53). It lists 7 CPT or HCPCS codes, 2 of them on the Anthem Blue Cross Blue Shield of California 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 Blue Shield of California prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of California policies |
|---|---|---|---|
| 96000 | Not listed | Policies naming 96000 | |
| 97760 | Not listed | Policies naming 97760 | |
| 97763 | Not listed | Policies naming 97763 | |
| 97799 | On the list | Unlisted physical medicine/rehabilitation service or procedure [when specified as biomagnetic therapy] or [when specified as sensory stimulation or coma stimulation therapy] or [when specified as isometric or isokinetic testing] | Policies naming 97799 |
| L2999 | On the list | Lower extremity orthosis, not otherwise specified | Policies naming L2999 |
| L3649 | Not listed | Policies naming L3649 | |
| T1999 | Not listed | Policies naming T1999 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list