Anthem Blue Cross and Blue Shield Nevada policy
CG-SURG-24 Functional Endoscopic Sinus Surgery (FESS)
CG-SURG-24 Functional Endoscopic Sinus Surgery (FESS) is a public Anthem Blue Cross and Blue Shield Nevada policy (policy CG-SURG-24). It lists 12 CPT or HCPCS codes, 12 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-SURG-24
- 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 |
|---|---|---|---|
| 31237 | On the list | Nasal/Sinus Endoscopy, Surgical; W/Bx, Polypectomy/Debridement (Sep Proc) | Policies naming 31237 |
| 31253 | On the list | Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when perfor | Policies naming 31253 |
| 31254 | On the list | Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior) | Policies naming 31254 |
| 31255 | On the list | Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior) | Policies naming 31255 |
| 31256 | On the list | Nasal/Sinus Endoscopy, Surgical, W/Maxillary Antrostomy | Policies naming 31256 |
| 31257 | On the list | Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy | Policies naming 31257 |
| 31259 | On the list | Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus | Policies naming 31259 |
| 31267 | On the list | Nasal/Sinus Endoscopy, Surgical, W/Maxillary Antrostomy; W/Maxillary Tissue Removal | Policies naming 31267 |
| 31276 | On the list | Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed | Policies naming 31276 |
| 31287 | On the list | Nasal/Sinus Endoscopy, Surgical, W/Sphenoidotomy | Policies naming 31287 |
| 31288 | On the list | Nasal/Sinus Endoscopy, Surgical, W/Sphenoidotomy; W/Tissue Removal, Sphenoid Sinus | Policies naming 31288 |
| S2342 | On the list | Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity( | Policies naming S2342 |
All Anthem Blue Cross and Blue Shield Nevada policies · Anthem Blue Cross and Blue Shield Nevada prior authorization CPT list