Anthem Blue Cross and Blue Shield Nevada policy
CG-MED-73 Hyperbaric Oxygen Therapy (Systemic/Topical)
CG-MED-73 Hyperbaric Oxygen Therapy (Systemic/Topical) is a public Anthem Blue Cross and Blue Shield Nevada policy (policy CG-MED-73). It lists 4 CPT or HCPCS codes, 3 of them on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-MED-73
- 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 and Blue Shield Nevada prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield Nevada policies |
|---|---|---|---|
| 00001 | Not listed | Policies naming 00001 | |
| 99183 | On the list | Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session | Policies naming 99183 |
| A4575 | On the list | Hyperbaric O2 Chamber Disps | Policies naming A4575 |
| G0277 | On the list | Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval | Policies naming G0277 |
All Anthem Blue Cross and Blue Shield Nevada policies · Anthem Blue Cross and Blue Shield Nevada prior authorization CPT list