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Anthem Blue Cross and Blue Shield Nevada prior authorization, page 17

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

Prior authorization codes
CodeDescriptionSource
37222Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to coNevada Prior Authorization List, Pg 39 Original policy
37223Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty withiNevada Prior Authorization List, Pg 39 Original policy
37224Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplastyNevada Prior Authorization List, Pg 39 Original policy
37225Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performedNevada Prior Authorization List, Pg 39 Original policy
37226Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vesNevada Prior Authorization List, Pg 40 Original policy
37227Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty witNevada Prior Authorization List, Pg 40 Original policy
37228Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplastyNevada Prior Authorization List, Pg 40 Original policy
37229Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, whenNevada Prior Authorization List, Pg 40 Original policy
37230Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within tNevada Prior Authorization List, Pg 40 Original policy
37231Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angiNevada Prior Authorization List, Pg 40 Original policy
37238Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vesNevada Prior Authorization List, Pg 40 Original policy
37241Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the iNevada Prior Authorization List, Pg 40 Original policy
37242Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the iNevada Prior Authorization List, Pg 40 Original policy
37243Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the iNevada Prior Authorization List, Pg 40 Original policy
37244Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the iNevada Prior Authorization List, Pg 40 Original policy
37248Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and intepretation necessary to perform angNevada Prior Authorization List, Pg 40 Original policy
37607Ligation/Banding, Angioaccess Arteriovenous FistulaNevada Prior Authorization List, Pg 40 Original policy
37609Ligation/Bx, Temporal ArteryNevada Prior Authorization List, Pg 40 Original policy
37761Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 legNevada Prior Authorization List, Pg 40 Original policy
38204Management, Recipient Hematopoietic Progenitor Cell Donor Search & Cell AcquisitionNevada Prior Authorization List, Pg 41 Original policy
38205Blood-Derived Hematopoietic Progenitor Cell Harvesting, Transplantation/Collection; AllogenicNevada Prior Authorization List, Pg 41 Original policy
38206Blood-Derived Hematopoietic Progenitor Cell Harvesting, Transplantation/Collection; AutologousNevada Prior Authorization List, Pg 41 Original policy
38207Transplant Preparation, Hematopoietic Progenitor Cells; Cryopreservation & StorageNevada Prior Authorization List, Pg 41 Original policy
38208Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donorNevada Prior Authorization List, Pg 41 Original policy
38209Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donorNevada Prior Authorization List, Pg 41 Original policy
38210Transplant Prep, Hematopoietic Progenitor Cells; Specfc Cell Deplet W/In Harvest, T-Cell DepleteNevada Prior Authorization List, Pg 41 Original policy
38211Transplant Preparation, Hematopoietic Progenitor Cells; Tumor Cell DepleteNevada Prior Authorization List, Pg 41 Original policy
38212Transplant Preparation, Hematopoietic Progenitor Cells; Red Blood Cell RemovalNevada Prior Authorization List, Pg 41 Original policy
38213Transplant Preparation, Hematopoietic Progenitor Cells; Platelet DepletionNevada Prior Authorization List, Pg 41 Original policy
38214Transplant Preparation, Hematopoietic Progenitor Cells; Plasma (Volume) DepletionNevada Prior Authorization List, Pg 41 Original policy
38215Transplant Prep, Hematoiepotic Progenitor Cells; Cell Conc, Plasma/Mononuclear/Buffy CoatNevada Prior Authorization List, Pg 41 Original policy
38221Diagnostic bone marrow; biopsy(ies)Nevada Prior Authorization List, Pg 41 Original policy
38222Diagnostic bone marrow; biopsy(ies) and aspiration(s)Nevada Prior Authorization List, Pg 41 Original policy
38230Bone marrow harvesting for transplantation; allogeneicNevada Prior Authorization List, Pg 41 Original policy
38232Bone Marrow Harvesting For Transplantation; AutologousNevada Prior Authorization List, Pg 42 Original policy
38240Hematopoietic progenitor cell (HPC); allogeneic transplantation per donorNevada Prior Authorization List, Pg 42 Original policy
38241Hematopoietic progenitor cell (HPC); autologous transplantationNevada Prior Authorization List, Pg 42 Original policy
38243Hematopoietic progenitor cell (HPC); HPC boostNevada Prior Authorization List, Pg 42 Original policy
38500Bx/Excision, Lymph Node(S); SuperficialNevada Prior Authorization List, Pg 42 Original policy
38505Bx/Excision, Lymph Node(S); Needle, SuperficialNevada Prior Authorization List, Pg 42 Original policy
38510Bx/Excision, Lymph Node(S); Open, Deep Cervical Node(S)Nevada Prior Authorization List, Pg 42 Original policy
38525Bx/Excision, Lymph Node(S); Open, Deep Axillary Node(S)Nevada Prior Authorization List, Pg 42 Original policy
38740Axillary Lymphadenectomy; SuperficialNevada Prior Authorization List, Pg 42 Original policy
38760Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure)Nevada Prior Authorization List, Pg 42 Original policy
40490Bx, LipNevada Prior Authorization List, Pg 42 Original policy
40510Excision, Lip; Transverse Wedge Excision W/Primary ClosureNevada Prior Authorization List, Pg 42 Original policy
40520Excision, Lip; V-Excision W/Primary Direct Linear ClosureNevada Prior Authorization List, Pg 42 Original policy
40525Excision, Lip; Full Thickness, Reconstruction W/Local FlapNevada Prior Authorization List, Pg 42 Original policy
40530Resection, Lip, > One-Fourth, W/O ReconstructionNevada Prior Authorization List, Pg 42 Original policy
40808Bx, Vestibule, MouthNevada Prior Authorization List, Pg 42 Original policy

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

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