Anthem Blue Cross Blue Shield of California policy
CG-SURG-79 Implantable Infusion Pumps
CG-SURG-79 Implantable Infusion Pumps is a public Anthem Blue Cross Blue Shield of California policy (policy CG-SURG-79). It lists 18 CPT or HCPCS codes, 14 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-SURG-79
- 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 |
|---|---|---|---|
| 36260 | On the list | Insertion of implantable intra-arterial infusion pump (e.g., for chemotherapy of liver) | Policies naming 36260 |
| 36261 | On the list | Revision of implanted intra-arterial infusion pump [when specified as replacement] | Policies naming 36261 |
| 36262 | On the list | Removal of implanted intra-arterial infusion pump | Policies naming 36262 |
| 36563 | On the list | Insertion of tunneled centrally inserted central venous access device with subcutaneous pump | Policies naming 36563 |
| 36583 | On the list | Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access | Policies naming 36583 |
| 61215 | On the list | Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter | Policies naming 61215 |
| 62350 | Not listed | Policies naming 62350 | |
| 62351 | Not listed | Policies naming 62351 | |
| 62360 | Not listed | Policies naming 62360 | |
| 62361 | On the list | Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump | Policies naming 62361 |
| 62362 | On the list | Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming | Policies naming 62362 |
| 62365 | On the list | Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion [when specified as pump removal] | Policies naming 62365 |
| C1772 | On the list | Infusion pump, programmable (implantable) | Policies naming C1772 |
| C1891 | Not listed | Policies naming C1891 | |
| C2626 | On the list | Infusion pump, nonprogrammable, temporary (implantable) | Policies naming C2626 |
| E0782 | On the list | Infusion pump, implantable, nonprogrammable (includes all components, e.g., pump, catheter, connectors, etc.) | Policies naming E0782 |
| E0783 | On the list | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Policies naming E0783 |
| E0786 | On the list | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Policies naming E0786 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list