Anthem Blue Cross and Blue Shield Nevada prior authorization
CPT code lookup
Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.
Prior authorization codes
| Code | Description | Source |
|---|---|---|
| 00170 | Anesthesia, Intraoral Proc, W/Bx; Nos | Nevada Prior Authorization List, Pg 2 Original policy |
| 00580 | Anesthesia, Heart Transplant/Heart & Lung Transplant | Nevada Prior Authorization List, Pg 2 Original policy |
| 00796 | Anesthesia, Intraperitoneal Proc, Upper Abdomen, W/Laparoscopy; Liver Transplant, Recipient | Nevada Prior Authorization List, Pg 2 Original policy |
| 00868 | Anesthesia, Extraperitoneal Proc, Lower Abdomen, W/Urinary Tract; Renal Transplant, Recipient | Nevada Prior Authorization List, Pg 2 Original policy |
| 01937 | Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic | Nevada Prior Authorization List, Pg 2 Original policy |
| 01938 | Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral | Nevada Prior Authorization List, Pg 2 Original policy |
| 01939 | Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic | Nevada Prior Authorization List, Pg 2 Original policy |
| 01940 | Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral | Nevada Prior Authorization List, Pg 2 Original policy |
| 01941 | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic | Nevada Prior Authorization List, Pg 2 Original policy |
| 01942 | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral | Nevada Prior Authorization List, Pg 2 Original policy |
| 01991 | Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional | Nevada Prior Authorization List, Pg 2 Original policy |
| 01992 | Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional | Nevada Prior Authorization List, Pg 2 Original policy |
| 10060 | Incision & Drainage, Abscess; Simple/Single | Nevada Prior Authorization List, Pg 2 Original policy |
| 10061 | Incision & Drainage, Abscess; Complicated/Multiple | Nevada Prior Authorization List, Pg 2 Original policy |
| 10080 | Incision & Drainage, Pilonidal Cyst; Simple | Nevada Prior Authorization List, Pg 2 Original policy |
| 10081 | Incision & Drainage, Pilonidal Cyst; Complicated | Nevada Prior Authorization List, Pg 2 Original policy |
| 10120 | Incision & Removal, Fb, Subq Tissues; Simple | Nevada Prior Authorization List, Pg 2 Original policy |
| 10121 | Incision & Removal, Fb, Subq Tissues; Complicated | Nevada Prior Authorization List, Pg 2 Original policy |
| 10140 | Incision & Drainage, Hematoma, Seroma/Fluid Collection | Nevada Prior Authorization List, Pg 2 Original policy |
| 10160 | Puncture Aspiration, Abscess, Hematoma, Bulla/Cyst | Nevada Prior Authorization List, Pg 2 Original policy |
| 10180 | Incision & Drainage, Complex, Postoperative Wound Infection | Nevada Prior Authorization List, Pg 2 Original policy |
| 11000 | Debridement, Extensive Eczematous/Infected Skin; Up To 10pct Body Surface | Nevada Prior Authorization List, Pg 2 Original policy |
| 11010 | Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues | Nevada Prior Authorization List, Pg 2 Original policy |
| 11012 | Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fa | Nevada Prior Authorization List, Pg 2 Original policy |
| 11042 | Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less | Nevada Prior Authorization List, Pg 3 Original policy |
| 11044 | Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less | Nevada Prior Authorization List, Pg 3 Original policy |
| 11200 | Removal, Skin Tags, Multiple Fibrocutaneous Tags, Any Area; Up To & Incl 15 Lesions | Nevada Prior Authorization List, Pg 3 Original policy |
| 11310 | Shaving Skin Lesion, Face/Ears/Eyelids/Nose/Lips/Mucous Membrane; Diameter 0.5 Cm/< | Nevada Prior Authorization List, Pg 3 Original policy |
| 11402 | Excise, Benign Skin Lesion, Incl Margins, Except Skin Tag, Trunk/Arms/Legs; Excised Diam 1.1-2.0 Cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11403 | Excise, Benign Skin Lesion, Incl Margins, Except Skin Tag, Trunk/Arms/Legs; Excised Diam 2.1-3.0 Cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11404 | Excise, Benign Skin Lesion, Incl Margins, Except Skin Tag, Trunk/Arms/Legs; Excised Diam 3.1-4.0 Cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11406 | Excise, Benign Skin Lesion, Incl Margins, Except Skin Tag, Trunk/Arms/Legs; Excised Diam > 4.0 Cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11420 | Excise Benign Skin Lesion W/Marg, Excpt Skin Tag Scalp/Neck/Hands/Feet/Genital; Excise Diam 0.5cm/< | Nevada Prior Authorization List, Pg 3 Original policy |
| 11421 | Excise Ben Skin Lesion W/Marg, Except Skin Tag Scalp/Neck/Hands/Feet/Genital; Excise Diam 0.6-1.0cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11422 | Excise Ben Skin Lesion W/Marg, Except Skin Tag Scalp/Neck/Hands/Feet/Genital; Excise Diam 1.1-2.0cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11423 | Excise Ben Skin Lesion W/Marg, Except Skin Tag Scalp/Neck/Hands/Feet/Genital; Excise Diam 2.1-3.0cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11424 | Excise Ben Skin Lesion W/Marg, Except Skin Tag Scalp/Neck/Hands/Feet/Genital; Excise Diam 3.1-4.0cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11426 | Excise Benign Skin Lesion W/Marg, Except Skin Tag Scalp/Neck/Hands/Ft/Genital; Excise Diam >4.0cm | Nevada Prior Authorization List, Pg 3 Original policy |
| 11440 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, l | Nevada Prior Authorization List, Pg 3 Original policy |
| 11441 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, l | Nevada Prior Authorization List, Pg 3 Original policy |
| 11442 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, l | Nevada Prior Authorization List, Pg 3 Original policy |
| 11443 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, l | Nevada Prior Authorization List, Pg 3 Original policy |
| 11444 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, l | Nevada Prior Authorization List, Pg 3 Original policy |
| 11446 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, l | Nevada Prior Authorization List, Pg 3 Original policy |
| 11450 | Excision, Skin & Subq Tissue, Hidradenitis, Axillary; Simple/Intermediate Repair | Nevada Prior Authorization List, Pg 3 Original policy |
| 11451 | Excision, Skin & Subq Tissue, Hidradenitis, Axillary; W/Complex Repair | Nevada Prior Authorization List, Pg 3 Original policy |
| 11462 | Excision, Skin & Subq Tissue, Hidradenitis, Inguinal; Simple/Intermediate Repair | Nevada Prior Authorization List, Pg 3 Original policy |
| 11463 | Excision, Skin & Subq Tissue, Hidradenitis, Inguinal; W/Complex Repair | Nevada Prior Authorization List, Pg 3 Original policy |
| 11470 | Excision, Skin & Subq Tissue, Hidradenitis, Perianal/Perineal/Umbilical; Simple/Intermediate Repair | Nevada Prior Authorization List, Pg 3 Original policy |
| 11471 | Excision, Skin & Subq Tissue, Hidradenitis, Perianal/Perineal/Umbilical; W/ Complex Repair | Nevada Prior Authorization List, Pg 3 Original policy |