Anthem Blue Cross Blue Shield of Georgia policy
CG-MED-78 Anesthesia Services for Interventional Pain Management Procedures
CG-MED-78 Anesthesia Services for Interventional Pain Management Procedures is a public Anthem Blue Cross Blue Shield of Georgia policy (policy CG-MED-78). It lists 8 CPT or HCPCS codes, 2 of them on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-MED-78
- 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 Georgia prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of Georgia policies |
|---|---|---|---|
| 01937 | Not listed | Policies naming 01937 | |
| 01938 | Not listed | Policies naming 01938 | |
| 01939 | Not listed | Policies naming 01939 | |
| 01940 | Not listed | Policies naming 01940 | |
| 01941 | On the list | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic | Policies naming 01941 |
| 01942 | On the list | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral | Policies naming 01942 |
| 01991 | Not listed | Policies naming 01991 | |
| 01992 | Not listed | Policies naming 01992 |
All Anthem Blue Cross Blue Shield of Georgia policies · Anthem Blue Cross Blue Shield of Georgia prior authorization CPT list