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Anthem Blue Cross and Blue Shield Nevada prior authorization, page 24

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
52281Cystourethroscopy, W/Calibration &/Or Dilation, Urethral Stricture/Stenosis, Male/FemaleNevada Prior Authorization List, Pg 53 Original policy
52282Cystourethroscopy, with insertion of permanent urethral stentNevada Prior Authorization List, Pg 53 Original policy
52283Cystourethroscopy, W/Steroid Injection Into StrictureNevada Prior Authorization List, Pg 53 Original policy
52285Cystourethroscopy, Treatment, Female Urethral SyndromeNevada Prior Authorization List, Pg 53 Original policy
52287Cystourethroscopy, with injection(s) for chemodenervation of the bladderNevada Prior Authorization List, Pg 53 Original policy
52300Cystourethroscopy; W/Resection/Fulguration, Orthotopic Ureterocele(S), Unilat/BilatNevada Prior Authorization List, Pg 53 Original policy
52310Cystourethroscopy, W/Removal, Fb/Calculus/Ureteral Stent; SimpleNevada Prior Authorization List, Pg 53 Original policy
52315Cystourethroscopy, W/Removal, Fb/Calculus/Ureteral Stent; ComplicatedNevada Prior Authorization List, Pg 53 Original policy
52317Litholapaxy; Simple/Small (< 2.5 Cm)Nevada Prior Authorization List, Pg 53 Original policy
52318Litholapaxy; Complicated/Large (> 2.5 Cm)Nevada Prior Authorization List, Pg 53 Original policy
52320Cystourethroscopy; W/Removal, Ureteral CalculusNevada Prior Authorization List, Pg 53 Original policy
52325Cystourethroscopy; W/Fragmentation, Ureteral CalculusNevada Prior Authorization List, Pg 53 Original policy
52327Cystourethroscopy; W/Subureteric Injection, Implant MatlNevada Prior Authorization List, Pg 53 Original policy
52330Cystourethroscopy; W/Manipulation, W/O Removal Ureteral CalculusNevada Prior Authorization List, Pg 53 Original policy
52332Cystourethroscopy, W/Insertion, Indwelling Ureteral StentNevada Prior Authorization List, Pg 53 Original policy
52341Cystourethroscopy; W/Treatment Ureteral StrictureNevada Prior Authorization List, Pg 54 Original policy
52344Cystourethroscopy W/Ureteroscopy; W/Treatment Ureteral StrictureNevada Prior Authorization List, Pg 54 Original policy
52351Cystourethroscopy W/Ureteroscopy &/Or Pyeloscopy; DiagnosticNevada Prior Authorization List, Pg 54 Original policy
52352Cystourethroscopy W/Ureteroscopy &/Or Pyeloscopy; W/Removal/Manipulation CalculusNevada Prior Authorization List, Pg 54 Original policy
52353Cystourethroscopy W/Ureteroscopy &/Or Pyeloscopy; W/LithotripsyNevada Prior Authorization List, Pg 54 Original policy
52354Cystourethroscopy W/Ureteroscopy &/Or Pyeloscopy; W/Bx &/Or Fulgurate Ureteral/Renal Pelvic LesionNevada Prior Authorization List, Pg 54 Original policy
52356Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)Nevada Prior Authorization List, Pg 54 Original policy
52450Transurethral Incision, ProstateNevada Prior Authorization List, Pg 54 Original policy
52500Transurethral resection of bladder neck (separate procedure)Nevada Prior Authorization List, Pg 54 Original policy
52510Transurethral balloon dilation of the prostatic urethraNevada Prior Authorization List, Pg 54 Original policy
52601Transurethral Electrosurgical Resection, Prostate, W/Control Postop Bleed, CompleteNevada Prior Authorization List, Pg 54 Original policy
52630Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleedingNevada Prior Authorization List, Pg 54 Original policy
52640Transurethral Resection; Postoperative Bladder Neck ContractureNevada Prior Authorization List, Pg 54 Original policy
53020Meatotomy, Cutting, Meatus (Sep Proc); Except InfantNevada Prior Authorization List, Pg 54 Original policy
53200Bx, UrethraNevada Prior Authorization List, Pg 54 Original policy
53230Excision, Urethral Diverticulum (Sep Proc); FemaleNevada Prior Authorization List, Pg 54 Original policy
53260Excision/Fulguration; Urethral Polyp(S), Distal UrethraNevada Prior Authorization List, Pg 54 Original policy
53265Excision/Fulguration; Urethral CaruncleNevada Prior Authorization List, Pg 54 Original policy
53270Excision/Fulguration; Skene's GlandsNevada Prior Authorization List, Pg 54 Original policy
53410Urethroplasty, 1-stage reconstruction of male anterior urethraNevada Prior Authorization List, Pg 54 Original policy
53420Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stageNevada Prior Authorization List, Pg 54 Original policy
53425Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stageNevada Prior Authorization List, Pg 54 Original policy
53430Urethroplasty, Reconstruction, Female UrethraNevada Prior Authorization List, Pg 54 Original policy
53440Sling Operation, Correction, Male Urinary IncontinenceNevada Prior Authorization List, Pg 54 Original policy
53445Insertion, Inflatable Urethra/Bladder Neck Sphincter, W/Placement Pump &/Or Reservoir & CuffNevada Prior Authorization List, Pg 54 Original policy
53446Removal, Inflatable Urethral/Bladder Neck Sphincter W/Pump/Reservoir/CuffNevada Prior Authorization List, Pg 54 Original policy
53447Removal & Replacement, Inflatable Sphincter W/Pump, Reservoir, Cuff, Same SessionNevada Prior Authorization List, Pg 54 Original policy
53448Remov & Replace Inflatable Sphincter W/Pump/Reservoir/Cuff, Infected, W/Irrig & DebrideNevada Prior Authorization List, Pg 54 Original policy
53449Repair, Inflatable Urethral/Bladder Neck Sphincter Device, Incl Pump/Reservoir/CuffNevada Prior Authorization List, Pg 55 Original policy
53450Urethromeatoplasty, W/Mucosal AdvancementNevada Prior Authorization List, Pg 55 Original policy
53451Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidanceNevada Prior Authorization List, Pg 55 Original policy
53452Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidanceNevada Prior Authorization List, Pg 55 Original policy
53453Periurethral transperineal adjustable balloon continence device; removal, each balloonNevada Prior Authorization List, Pg 55 Original policy
53454Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volumeNevada Prior Authorization List, Pg 55 Original policy
53500Urethrolysis, Transvaginal, Secondary, Open, Including Cystourethroscopy (Eg, Postsurgical Obstruction, Scarring)Nevada Prior Authorization List, Pg 55 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.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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