Anthem Blue Cross Blue Shield of California policy
CG-MED-66 Cryopreservation of Oocytes or Ovarian Tissue
CG-MED-66 Cryopreservation of Oocytes or Ovarian Tissue is a public Anthem Blue Cross Blue Shield of California policy (policy CG-MED-66). It lists 6 CPT or HCPCS codes, 6 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-MED-66
- 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 |
|---|---|---|---|
| 89337 | On the list | Cryopreservation, mature oocyte(s) | Policies naming 89337 |
| 89344 | On the list | Storage, (per year); reproductive tissue, testicular/ovarian [when specified as ovarian tissue] | Policies naming 89344 |
| 89346 | On the list | Storage (per year); oocyte(s) | Policies naming 89346 |
| 89354 | On the list | Thawing of cryopreserved; reproductive tissue, testicular/ovarian [when specified as ovarian tissue] | Policies naming 89354 |
| 89356 | On the list | Thawing of cryopreserved; oocytes, each aliquot | Policies naming 89356 |
| 89398 | On the list | Unlisted reproductive medicine laboratory procedure [when specified as a sperm DNA fragmentation test] | Policies naming 89398 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list