Anthem Blue Cross Blue Shield of Colorado policy
ANC.00009 Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities
ANC.00009 Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities is a public Anthem Blue Cross Blue Shield of Colorado policy (policy ANC.00009). It lists 23 CPT or HCPCS codes, 18 of them on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage decision; the payer's own document governs.
- Policy number
- ANC.00009
- 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 Colorado prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of Colorado policies |
|---|---|---|---|
| 15832 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh | Policies naming 15832 |
| 15833 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg | Policies naming 15833 |
| 15834 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip | Policies naming 15834 |
| 15835 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock | Policies naming 15835 |
| 15836 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm | Policies naming 15836 |
| 15837 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand | Policies naming 15837 |
| 15839 | On the list | Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area | Policies naming 15839 |
| 15877 | On the list | Suction Assisted Lipectomy; Trunk | Policies naming 15877 |
| 15878 | On the list | Suction Assisted Lipectomy; Upper Extremity | Policies naming 15878 |
| 15879 | On the list | Suction Assisted Lipectomy; Lower Extremity | Policies naming 15879 |
| 21740 | On the list | Reconstructive Repair, Pectus Excavatum/Carinatum; Open | Policies naming 21740 |
| 21742 | On the list | Reconstructive Repair, Pectus Excavatum/Carinatum; Minimal Invasive Approach, W/O Thoracoscopy | Policies naming 21742 |
| 21743 | On the list | Reconstructive Repair, Pectus Excavatum/Carinatum; Minimal Invasive Approach, W/Thoracoscopy | Policies naming 21743 |
| 54360 | On the list | Plastic Operation, Penis To Correct Angulation | Policies naming 54360 |
| 54440 | On the list | Plastic Operation, Penis, Injury | Policies naming 54440 |
| 55899 | Not listed | Policies naming 55899 | |
| 56800 | Not listed | Policies naming 56800 | |
| 56805 | On the list | Clitoroplasty, Intersex State | Policies naming 56805 |
| 56810 | On the list | Perineoplasty, Repair, Perineum, Nonobstetrical (Sep Proc) | Policies naming 56810 |
| 57291 | Not listed | Policies naming 57291 | |
| 57292 | Not listed | Policies naming 57292 | |
| 57335 | On the list | Vaginoplasty, Intersex State | Policies naming 57335 |
| 58999 | Not listed | Policies naming 58999 |
All Anthem Blue Cross Blue Shield of Colorado policies · Anthem Blue Cross Blue Shield of Colorado prior authorization CPT list