Anthem Blue Cross Blue Shield of Georgia policy
TRANS.00037 Uterine Transplantation
TRANS.00037 Uterine Transplantation is a public Anthem Blue Cross Blue Shield of Georgia policy (policy TRANS.00037). It lists 7 CPT or HCPCS codes, 7 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
- TRANS.00037
- 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 |
|---|---|---|---|
| 0664T | On the list | Donor hysterectomy (including cold preservation); open, from cadaver donor | Policies naming 0664T |
| 0665T | On the list | Donor hysterectomy (including cold preservation); open, from living donor | Policies naming 0665T |
| 0666T | On the list | Donor hysterectomy (including cold preservation); laparoscopic or robotic, from living donor | Policies naming 0666T |
| 0667T | On the list | Recipient uterus allograft transplantation from cadaver or living donor | Policies naming 0667T |
| 0668T | On the list | Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation, including dissection and removal of surrounding soft tissues and preparation of uterine vein(s) and uterine artery(ies), as necessary | Policies naming 0668T |
| 0669T | On the list | Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis, each | Policies naming 0669T |
| 0670T | On the list | Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis, each | Policies naming 0670T |
All Anthem Blue Cross Blue Shield of Georgia policies · Anthem Blue Cross Blue Shield of Georgia prior authorization CPT list