Anthem Blue Cross Blue Shield of California policy
Code and Clinical Editing Guidelines - Professional
Code and Clinical Editing Guidelines - Professional is a public Anthem Blue Cross Blue Shield of California policy (policy C-09004, effective Jul 1, 2024). It lists 11 CPT or HCPCS codes, 11 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
- C-09004
- Effective
- Jul 1, 2024
- Line of business
- Commercial
- States
- CA
- 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 |
|---|---|---|---|
| 22206 | On the list | Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (e.g., pedicle/vertebral body subtraction); thoracic | Policies naming 22206 |
| 22207 | On the list | Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (e.g., pedicle/vertebral body subtraction); lumbar | Policies naming 22207 |
| 22208 | On the list | Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (e.g., pedicle/vertebral body subtraction); each additional vertebral segment (List separately in addition to code for primary procedure) | Policies naming 22208 |
| 22210 | On the list | Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical | Policies naming 22210 |
| 22212 | On the list | Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic | Policies naming 22212 |
| 22214 | On the list | Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar | Policies naming 22214 |
| 22216 | On the list | Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure) | Policies naming 22216 |
| 22220 | On the list | Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical | Policies naming 22220 |
| 22222 | On the list | Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic | Policies naming 22222 |
| 22224 | On the list | Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar | Policies naming 22224 |
| 22226 | On the list | Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (List separately in addition to code for primary procedure) | Policies naming 22226 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list