Anthem Blue Cross and Blue Shield Nevada policy

Modifiers 80, 81, 82 and AS: Assistant at Surgery - Professional

Modifiers 80, 81, 82 and AS: Assistant at Surgery - Professional is a public Anthem Blue Cross and Blue Shield Nevada policy (policy C-08006, effective Sep 27, 2023). It lists 44 CPT or HCPCS codes, 17 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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Payer
Anthem Blue Cross and Blue Shield Nevada
Policy number
C-08006
Effective
Sep 27, 2023
Line of business
Commercial
States
CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI
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.

CodePrior authorizationDescription on the prior authorization listOther Anthem Blue Cross and Blue Shield Nevada policies
0302TNot listedPolicies naming 0302T
0303TNot listedPolicies naming 0303T
0304TNot listedPolicies naming 0304T
0307TNot listedPolicies naming 0307T
0308TNot listedPolicies naming 0308T
0347TNot listedPolicies naming 0347T
0356TNot listedPolicies naming 0356T
0437TNot listedPolicies naming 0437T
0438TNot listedPolicies naming 0438T
0440TOn the listAblation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nervePolicies naming 0440T
0441TOn the listAblation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nervePolicies naming 0441T
0442TOn the listAblation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)Policies naming 0442T
0444TNot listedPolicies naming 0444T
0445TNot listedPolicies naming 0445T
0474TOn the listInsertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary spacePolicies naming 0474T
0479TNot listedPolicies naming 0479T
0483TOn the listTranscatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performedPolicies naming 0483T
0484TOn the listTranscatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)Policies naming 0484T
15733Not listedPolicies naming 15733
19294Not listedPolicies naming 19294
20939On the listBone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure)Policies naming 20939
29838Not listedPolicies naming 29838
31241Not listedPolicies naming 31241
31253On the listNasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when perforPolicies naming 31253
31257On the listNasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomyPolicies naming 31257
31259On the listNasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinusPolicies naming 31259
31298On the listNasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostiaPolicies naming 31298
32994On the listAblation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imagingPolicies naming 32994
36465On the listInjection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; singlPolicies naming 36465
36466On the listInjection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiPolicies naming 36466
36482On the listEndovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of allPolicies naming 36482
36483Not listedPolicies naming 36483
38222On the listDiagnostic bone marrow; biopsy(ies) and aspiration(s)Policies naming 38222
55874On the listTransperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performedPolicies naming 55874
61645Not listedPolicies naming 61645
C9724Not listedPolicies naming C9724
C9725Not listedPolicies naming C9725
C9732Not listedPolicies naming C9732
C9738Not listedPolicies naming C9738
C9748Not listedPolicies naming C9748
C9749Not listedPolicies naming C9749
G0516Not listedPolicies naming G0516
G0517Not listedPolicies naming G0517
G0518Not listedPolicies naming G0518

All Anthem Blue Cross and Blue Shield Nevada policies · Anthem Blue Cross and Blue Shield Nevada prior authorization CPT list

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