Anthem Blue Cross Blue Shield of California policies, page 6

Search Anthem Blue Cross Blue Shield of California's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

576 public policies Substrate tracks for Anthem Blue Cross Blue Shield of California, by title.

Anthem Blue Cross Blue Shield of California policies
PolicyDetailsCodesSource
CG-SURG-83 Bariatric Surgery and Other Treatments for Clinically Severe ObesityCG-SURG-83 · Commercial27Original policy ↗
CG-SURG-84 Mandibular/Maxillary (Orthognathic) SurgeryCG-SURG-84 · Commercial45Original policy ↗
CG-SURG-88 Mastectomy for GynecomastiaCG-SURG-88 · Commercial2Original policy ↗
CG-SURG-89 Radiofrequency Neurolysis and Pulsed Radiofrequency Therapy for Trigeminal NeuralgiaCG-SURG-89 · Commercial6Original policy ↗
CG-SURG-90 Mohs Micrographic SurgeryCG-SURG-90 · Commercial5Original policy ↗
CG-SURG-91 Minimally Invasive Ablative Procedures for EpilepsyCG-SURG-91 · Commercial4Original policy ↗
CG-SURG-92 Paraesophageal Hernia RepairCG-SURG-92 · Commercial8Original policy ↗
CG-SURG-99 Panniculectomy and AbdominoplastyCG-SURG-99 · Commercial5Original policy ↗
CG-THER-RAD-07 Intravascular Coronary and Non-Coronary BrachytherapyCG-THER-RAD-07 · Commercial6Original policy ↗
CG-TRANS-02 Kidney TransplantationCG-TRANS-02 · Commercial12Original policy ↗
CG-TRANS-03 Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell TransplantationCG-TRANS-03 · Commercial2Original policy ↗
Claims Requiring Additional Documentation – Professional and FacilityC-22001 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Clinic Charges – FacilityC-14002 · Effective Apr 1, 2026 · Commercial · CA—Original policy ↗
Clinical and ADT Data SharingEffective Jan 1, 2021 · Commercial · CA32Original policy ↗
Clinical Guidelines adopted by California HMOCA-BC-CM-021940-26-S5902 · Commercial · CA—Original policy ↗
Clinical UM Guidelines adopted by Anthem Blue Cross (PPO)Commercial · CA—Original policy ↗
Coblation® Therapies for Musculoskeletal ConditionsSURG.00088 · Commercial2Original policy ↗
Code and Clinical Editing Guidelines - ProfessionalC-09004 · Effective Jul 1, 2024 · Commercial · CA11Original policy ↗
Code and Clinical Editing Guidelines – Professional and FacilityC-25002 · Effective Jan 1, 2027 · Commercial · CA—Original policy ↗
Coding Compensation Collaboration PolicyCommercial · CA—Original policy ↗
Coding Compensation Collaboration PolicyCommercial · CA—Original policy ↗
Commercial Medical Record Review Process and StandardsCommercial · CA—Original policy ↗
Commercial Medical Record Review Process and StandardsCommercial · CA—Original policy ↗
Commercial Risk Adjustment: Program OverviewCommercial · CA—Original policy ↗
COMPLEX CASE MANAGEMENT DISEASE MANAGEMENT GUIDELINE WORKBOOKCommercial · CA—Original policy ↗
Consultation Services – ProfessionalC-09010 · Effective Oct 1, 2026 · Commercial · CA10Original policy ↗
Cost Data Reports via AvailityCommercial · CA—Original policy ↗
Credentialing Guideline WorkbookCommercial, Medicaid · CA—Original policy ↗
Critical Care to Home – FacilityC-25004 · Effective Oct 1, 2026 · Commercial · CA6Original policy ↗
Cryoablation for Plantar Fasciitis and Plantar FibromaSURG.00100 · Commercial2Original policy ↗
Cryosurgical, Radiofrequency, Microwave or Laser Ablation to Treat Solid Tumors Outside the LiverCG-SURG-61 · Commercial25Original policy ↗
Deep Brain Stimulation and Responsive NeurostimulationSURG.00026 · Commercial22Original policy ↗
Delegated HMO Capitation File Reporting Changes for California Senate Bill 138 Sensitive Service Confidential CommunicationCommercial · CA—Original policy ↗
Dental Claims Submission RequirementsCommercial · CA125Original policy ↗
Dental Web Portal NotificationCommercial · CA—Original policy ↗
Destruction of Pre-Malignant Skin LesionsCG-SURG-37 · Commercial3Original policy ↗
Diagnostic Radiopharmaceuticals and Contrast Materials - Professional and FacilityC-24001 · Effective Apr 1, 2026 · Commercial · CA—Original policy ↗
Digital Availity Enrollment Guide Behavioral HealthCommercial · CA—Original policy ↗
Digital Availity Enrollment Guide Non Credentialed PPOCommercial · CA—Original policy ↗
Digital Availity Enrollment Guide PPOCommercial · CA—Original policy ↗
DME Modifiers - ProfessionalC-19006 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
DME Rent To Purchase – ProfessionalC-19007 · Effective Jan 1, 2026 · Commercial · CA8Original policy ↗
DME Rent To Purchase – ProfessionalC-19007 · Effective Jan 1, 2027 · Commercial · CA8Original policy ↗
DME.00012 Intrapulmonary Percussive Ventilation DevicesDME.00012 · Commercial1Original policy ↗
DME.00022 Functional Electrical Stimulation (FES); Threshold Electrical Stimulation (TES)DME.00022 · Commercial5Original policy ↗
DME.00030 Altered Auditory Feedback Devices for Fluency DisordersDME.00030 · Commercial1Original policy ↗
DME.00037 Cooling Devices and Combined Cooling/Heating DevicesDME.00037 · Commercial6Original policy ↗
DME.00038 Static Progressive Stretch (SPS) and Patient-Actuated Serial Stretch (PASS) DevicesDME.00038 · Commercial9Original policy ↗
DME.00046 Intermittent Abdominal Pressure Ventilation DevicesDME.00046 · Commercial1Original policy ↗
DME.00047 Rehabilitative Devices with Remote MonitoringDME.00047 · Commercial1Original policy ↗

Back to Anthem Blue Cross Blue Shield of California · Anthem Blue Cross Blue Shield of California prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.