Anthem Blue Cross Blue Shield of Colorado policy

Anthem Blue Cross and Blue Shield Provider and Facility Manual

Anthem Blue Cross and Blue Shield Provider and Facility Manual is a public Anthem Blue Cross Blue Shield of Colorado policy (effective Aug 1, 2016). It lists 116 CPT or HCPCS codes, 4 of them on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Anthem Blue Cross Blue Shield of Colorado
Effective
Aug 1, 2016
Line of business
Commercial
States
CO
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.

CodePrior authorizationDescription on the prior authorization listOther Anthem Blue Cross Blue Shield of Colorado policies
00001Not listedPolicies naming 00001
00004Not listedPolicies naming 00004
00005Not listedPolicies naming 00005
00100Not listedPolicies naming 00100
01999Not listedPolicies naming 01999
10000Not listedPolicies naming 10000
1000BNot listedPolicies naming 1000B
12345Not listedPolicies naming 12345
25021Not listedPolicies naming 25021
30348Not listedPolicies naming 30348
36415Not listedPolicies naming 36415
36416Not listedPolicies naming 36416
36591Not listedPolicies naming 36591
36592Not listedPolicies naming 36592
44135On the listIntestinal Allotransplantation; From Cadaver DonorPolicies naming 44135
44193Not listedPolicies naming 44193
60197Not listedPolicies naming 60197
69999Not listedPolicies naming 69999
70000Not listedPolicies naming 70000
73651Not listedPolicies naming 73651
76376On the list3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under coPolicies naming 76376
76377On the list3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under coPolicies naming 76377
79999Not listedPolicies naming 79999
80000Not listedPolicies naming 80000
80048Not listedPolicies naming 80048
80202Not listedPolicies naming 80202
80217Not listedPolicies naming 80217
80273Not listedPolicies naming 80273
81000Not listedPolicies naming 81000
81001Not listedPolicies naming 81001
81002Not listedPolicies naming 81002
81003Not listedPolicies naming 81003
81005Not listedPolicies naming 81005
81007Not listedPolicies naming 81007
81015Not listedPolicies naming 81015
81025Not listedPolicies naming 81025
82120Not listedPolicies naming 82120
82270Not listedPolicies naming 82270
82271Not listedPolicies naming 82271
82803Not listedPolicies naming 82803
82947Not listedPolicies naming 82947
82948Not listedPolicies naming 82948
82962Not listedPolicies naming 82962
83986Not listedPolicies naming 83986
85002Not listedPolicies naming 85002
85007Not listedPolicies naming 85007
85013Not listedPolicies naming 85013
85014Not listedPolicies naming 85014
85018Not listedPolicies naming 85018
85025Not listedPolicies naming 85025
85610Not listedPolicies naming 85610
86308Not listedPolicies naming 86308
86403Not listedPolicies naming 86403
86580Not listedPolicies naming 86580
87081Not listedPolicies naming 87081
87205Not listedPolicies naming 87205
87210Not listedPolicies naming 87210
87220Not listedPolicies naming 87220
87430Not listedPolicies naming 87430
87802Not listedPolicies naming 87802
87804Not listedPolicies naming 87804
87807Not listedPolicies naming 87807
87880Not listedPolicies naming 87880
88141Not listedPolicies naming 88141
88142Not listedPolicies naming 88142
88154Not listedPolicies naming 88154
88155Not listedPolicies naming 88155
88164Not listedPolicies naming 88164
88167Not listedPolicies naming 88167
88172Not listedPolicies naming 88172
88173Not listedPolicies naming 88173
88174Not listedPolicies naming 88174
88175Not listedPolicies naming 88175
88177Not listedPolicies naming 88177
89300Not listedPolicies naming 89300
89310Not listedPolicies naming 89310
89320Not listedPolicies naming 89320
89321Not listedPolicies naming 89321
89330On the listSperm Evaluation; Cervical Mucus Penetration Test, W/Wo Spinnbarkeit TestPolicies naming 89330
89999Not listedPolicies naming 89999
90000Not listedPolicies naming 90000
92420Not listedPolicies naming 92420
92799Not listedPolicies naming 92799
95825Not listedPolicies naming 95825
98000Not listedPolicies naming 98000
99000Not listedPolicies naming 99000
99050Not listedPolicies naming 99050
99051Not listedPolicies naming 99051
99143Not listedPolicies naming 99143
99144Not listedPolicies naming 99144
99201Not listedPolicies naming 99201
99281Not listedPolicies naming 99281
99282Not listedPolicies naming 99282
99283Not listedPolicies naming 99283
99284Not listedPolicies naming 99284
99285Not listedPolicies naming 99285
99499Not listedPolicies naming 99499
99999Not listedPolicies naming 99999
E1399Not listedPolicies naming E1399
G0027Not listedPolicies naming G0027
G0380Not listedPolicies naming G0380
G0381Not listedPolicies naming G0381
G0382Not listedPolicies naming G0382
G0383Not listedPolicies naming G0383
G0384Not listedPolicies naming G0384
J0610Not listedPolicies naming J0610
J3490Not listedPolicies naming J3490
J8999Not listedPolicies naming J8999
J9999Not listedPolicies naming J9999
L0099Not listedPolicies naming L0099
L9900Not listedPolicies naming L9900
P3000Not listedPolicies naming P3000
P3001Not listedPolicies naming P3001
Q0091Not listedPolicies naming Q0091
S2900Not listedPolicies naming S2900
S9529Not listedPolicies naming S9529

All Anthem Blue Cross Blue Shield of Colorado policies · Anthem Blue Cross Blue Shield of Colorado 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.