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L8699 prior authorization | Anthem Blue Cross Blue Shield of California

L8699, Prosthetic implant, not otherwise specified [when specified as hybrid cochlear device, including all internal and external components] or [when describing replacement components of an auditory brain stem implant] or [when specified as a hyaluronic acid gel agent such as Juvederm or Restylane] or [when describing a prefabricated, custom-fitted auricular implant] or [when describing a custom-fabricated auricular implant] or [when specified as testicular or penile prosthesis], is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code
L8699
Description
Prosthetic implant, not otherwise specified [when specified as hybrid cochlear device, including all internal and external components] or [when describing replacement components of an auditory brain stem implant] or [when specified as a hyaluronic acid gel agent such as Juvederm or Restylane] or [when describing a prefabricated, custom-fitted auricular implant] or [when describing a custom-fabricated auricular implant] or [when specified as testicular or penile prosthesis]
Source
California PPO Prior Authorization List, Pg 28 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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