Anthem Blue Cross Blue Shield of California policy
SURG.00135 Renal Sympathetic Nerve Ablation
SURG.00135 Renal Sympathetic Nerve Ablation is a public Anthem Blue Cross Blue Shield of California policy (policy SURG.00135). It lists 5 CPT or HCPCS codes, 5 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
- SURG.00135
- 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 |
|---|---|---|---|
| 0338T | On the list | Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; unilateral | Policies naming 0338T |
| 0339T | On the list | Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; bilateral | Policies naming 0339T |
| 0935T | On the list | Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral | Policies naming 0935T |
| C1735 | On the list | Catheter(s), intravascular for renal denervation, radiofrequency, including all single use system components | Policies naming C1735 |
| C1736 | On the list | Catheter(s), intravascular for renal denervation, ultrasound, including all single use system components | Policies naming C1736 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list