Anthem Blue Cross and Blue Shield Nevada prior authorization, page 22
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 |
|---|---|---|
| 46947 | Hemorrhoidopexy (Eg, For Prolapsing Internal Hemorrhoids) By Stapling | Nevada Prior Authorization List, Pg 49 Original policy |
| 46948 | Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed | Nevada Prior Authorization List, Pg 49 Original policy |
| 47000 | Biopsy Of Liver, Needle; Percutaneous | Nevada Prior Authorization List, Pg 49 Original policy |
| 47133 | Donor Hepatectomy, W/Preparation & Maintenance, Allograft; Cadaver Donor | Nevada Prior Authorization List, Pg 49 Original policy |
| 47135 | Liver Allotransplantation; Orthotopic, Partial/Whole, Cadaver/Living Donor, Any Age | Nevada Prior Authorization List, Pg 49 Original policy |
| 47140 | Donor Hepatectomy, with Preparation and Maintenance of Allograft, Living Donor; Left Lateral Segment Only | Nevada Prior Authorization List, Pg 49 Original policy |
| 47141 | Donor Hepatectomy, with Preparation and Maintenance of Allograft, Living Donor; Total Left Lobectomy | Nevada Prior Authorization List, Pg 49 Original policy |
| 47142 | Donor Hepatectomy, with Preparation and Maintenance of Allograft, Living Donor; Total Right Lobectomy | Nevada Prior Authorization List, Pg 49 Original policy |
| 47143 | Backbench Standard Preparation Of Cadaver Donor Whole Liver Graft; Without Trisegment Or Lobe Split | Nevada Prior Authorization List, Pg 49 Original policy |
| 47144 | Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectom | Nevada Prior Authorization List, Pg 49 Original policy |
| 47145 | Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectom | Nevada Prior Authorization List, Pg 49 Original policy |
| 47146 | Backbench Reconstruction Of Cadaver Or Living Donor Liver Graft Prior To Allotransplantation; Venous Anastomosis, Each | Nevada Prior Authorization List, Pg 49 Original policy |
| 47147 | Backbench Reconstruction Of Cadaver Or Living Donor Liver Graft Prior To Allotransplantation; Arterial Anastomosis, Each | Nevada Prior Authorization List, Pg 49 Original policy |
| 48160 | Pancreatectomy, Total/Subtotal W/Autologous Transplantation Pancreas/Pancreatic Islets | Nevada Prior Authorization List, Pg 49 Original policy |
| 48550 | Donor Pancreatectomy, W/Prep & Maintenance, Cadaver Donor, W/Wo Duodenal Segment | Nevada Prior Authorization List, Pg 49 Original policy |
| 48551 | Backbench Standard Preparation Of Cadaver Donor Pancreas Allograft | Nevada Prior Authorization List, Pg 49 Original policy |
| 48552 | Backbench Reconstruction Of Cadaver Donor Pancreas Allograft Prior To Transplantation, Venous Anastomosis, Each | Nevada Prior Authorization List, Pg 49 Original policy |
| 48554 | Transplantation, Pancreatic Allograft | Nevada Prior Authorization List, Pg 49 Original policy |
| 48556 | Removal, Transplanted Pancreatic Allograft | Nevada Prior Authorization List, Pg 49 Original policy |
| 49083 | Abdominal Paracentesis (Diagnostic Or Therapeutic); With Imaging Guidance | Nevada Prior Authorization List, Pg 49 Original policy |
| 49180 | Bx, Abdominal/Retroperitoneal Mass, Percutaneous Needle | Nevada Prior Authorization List, Pg 49 Original policy |
| 49500 | Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible | Nevada Prior Authorization List, Pg 49 Original policy |
| 49505 | Repair initial inguinal hernia, age 5 years or older; reducible | Nevada Prior Authorization List, Pg 49 Original policy |
| 49507 | Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated | Nevada Prior Authorization List, Pg 49 Original policy |
| 49520 | Repair, Recurrent Inguinal Hernia, Any Age; Reducible | Nevada Prior Authorization List, Pg 50 Original policy |
| 49521 | Repair, Recurrent Inguinal Hernia, Any Age; Incarcerated/Strangulated | Nevada Prior Authorization List, Pg 50 Original policy |
| 49525 | Repair, Inguinal Hernia, Sliding, Any Age | Nevada Prior Authorization List, Pg 50 Original policy |
| 49550 | Repair, Initial Femoral Hernia, Any Age; Reducible | Nevada Prior Authorization List, Pg 50 Original policy |
| 49553 | Repair, Initial Femoral Hernia, Any Age; Incarcerated/Strangulated | Nevada Prior Authorization List, Pg 50 Original policy |
| 49560 | Repair, Initial Incisional/Ventral Hernia; Reducible | Nevada Prior Authorization List, Pg 50 Original policy |
| 49561 | Repair, Initial Incisional/Ventral Hernia; Incarcerated/Strangulated | Nevada Prior Authorization List, Pg 50 Original policy |
| 49570 | Repair, Epigastric Hernia; Reducible (Sep Proc) | Nevada Prior Authorization List, Pg 50 Original policy |
| 49572 | Repair, Epigastric Hernia; Incarcerated/Strangulated | Nevada Prior Authorization List, Pg 50 Original policy |
| 49585 | Repair umbilical hernia, age 5 years or older; reducible | Nevada Prior Authorization List, Pg 50 Original policy |
| 49587 | Repair umbilical hernia, age 5 years or older; incarcerated or strangulated | Nevada Prior Authorization List, Pg 50 Original policy |
| 49591 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implanta | Nevada Prior Authorization List, Pg 50 Original policy |
| 49592 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implanta | Nevada Prior Authorization List, Pg 50 Original policy |
| 49593 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implanta | Nevada Prior Authorization List, Pg 50 Original policy |
| 49594 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implanta | Nevada Prior Authorization List, Pg 50 Original policy |
| 49595 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implanta | Nevada Prior Authorization List, Pg 50 Original policy |
| 49596 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implanta | Nevada Prior Authorization List, Pg 50 Original policy |
| 49613 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implan | Nevada Prior Authorization List, Pg 51 Original policy |
| 49614 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implan | Nevada Prior Authorization List, Pg 51 Original policy |
| 49615 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implan | Nevada Prior Authorization List, Pg 51 Original policy |
| 49616 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implan | Nevada Prior Authorization List, Pg 51 Original policy |
| 49617 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implan | Nevada Prior Authorization List, Pg 51 Original policy |
| 49618 | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implan | Nevada Prior Authorization List, Pg 51 Original policy |
| 49650 | Laparoscopy, Surgical; Repair, Inguinal Hernia, Initial | Nevada Prior Authorization List, Pg 51 Original policy |
| 49651 | Laparoscopy, Surgical; Repair, Inguinal Hernia, Recurrent | Nevada Prior Authorization List, Pg 51 Original policy |
| 49652 | Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when perform | Nevada Prior Authorization List, Pg 51 Original policy |