Anthem Blue Cross Blue Shield of California policy
LAB.00027 Selected Blood, Serum and Cellular Allergy and Toxicity Tests
LAB.00027 Selected Blood, Serum and Cellular Allergy and Toxicity Tests is a public Anthem Blue Cross Blue Shield of California policy (policy LAB.00027). It lists 7 CPT or HCPCS codes, 7 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
- LAB.00027
- 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 |
|---|---|---|---|
| 82787 | On the list | Gammaglobulin (immunoglobulin); immunoglobulin subclasses (e.g., IgG1, 2, 3, or 4), each | Policies naming 82787 |
| 83516 | On the list | Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method [when specified as ALCAT or Mediator Release Test (MRT)] | Policies naming 83516 |
| 83520 | On the list | Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified or [when specified as testing for food allergy or sensitivity (e.g., IgG testing)] or [when specified as tau protein, amyloid beta peptide testing] | Policies naming 83520 |
| 86001 | On the list | Allergen specific IgG quantitative or semiquantitative, each allergen | Policies naming 86001 |
| 86343 | On the list | Leukocyte histamine release test (LHR) [includes basophil histamine release test] | Policies naming 86343 |
| 86849 | On the list | Unlisted immunology procedure [when specified as in vitro chemosensitivity or in vitro chemoresistance assay, ex vivo analysis of programmed cell death] or [when specified as Complement Antigen Test for delayed food allergy, Mediator Release Test (MRT), or Basophil Activation Test (BAT) by flow cytometry] | Policies naming 86849 |
| 95199 | On the list | Unlisted allergy/clinical immunologic service or procedure [when specified as cytotoxic testing for allergies] | Policies naming 95199 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list