Anthem Blue Cross and Blue Shield Nevada policy
Three-Dimensional (3D) Radiology Services – Professional and Facility
Three-Dimensional (3D) Radiology Services – Professional and Facility is a public Anthem Blue Cross and Blue Shield Nevada policy (policy C-22004, effective May 1, 2026). It lists 2 CPT or HCPCS codes, 2 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
- C-22004
- Effective
- May 1, 2026
- 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.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield Nevada policies |
|---|---|---|---|
| 76376 | On the list | 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under co | Policies naming 76376 |
| 76377 | On the list | 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under co | Policies naming 76377 |
All Anthem Blue Cross and Blue Shield Nevada policies · Anthem Blue Cross and Blue Shield Nevada prior authorization CPT list