Anthem Blue Cross and Blue Shield New Hampshire policy
NEW HAMPSHIRE PROVIDER MANUAL
NEW HAMPSHIRE PROVIDER MANUAL is a public Anthem Blue Cross and Blue Shield New Hampshire policy (effective Jul 1, 2020). It lists 25 CPT or HCPCS codes, 1 of them on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage decision; the payer's own document governs.
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- Effective
- Jul 1, 2020
- Line of business
- Commercial
- States
- NH
- 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 New Hampshire prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield New Hampshire policies |
|---|---|---|---|
| 01967 | Not listed | Policies naming 01967 | |
| 36415 | Not listed | Policies naming 36415 | |
| 36416 | Not listed | Policies naming 36416 | |
| 59400 | Not listed | Policies naming 59400 | |
| 59410 | Not listed | Policies naming 59410 | |
| 59510 | Not listed | Policies naming 59510 | |
| 59515 | Not listed | Policies naming 59515 | |
| 59610 | Not listed | Policies naming 59610 | |
| 59612 | Not listed | Policies naming 59612 | |
| 59614 | Not listed | Policies naming 59614 | |
| 59618 | Not listed | Policies naming 59618 | |
| 59620 | Not listed | Policies naming 59620 | |
| 59622 | Not listed | Policies naming 59622 | |
| 94760 | Not listed | Policies naming 94760 | |
| 94761 | Not listed | Policies naming 94761 | |
| 94762 | Not listed | Policies naming 94762 | |
| 96365 | On the list | Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour | Policies naming 96365 |
| 96366 | Not listed | Policies naming 96366 | |
| 96368 | Not listed | Policies naming 96368 | |
| 96374 | Not listed | Policies naming 96374 | |
| 96379 | Not listed | Policies naming 96379 | |
| 99001 | Not listed | Policies naming 99001 | |
| G0001 | Not listed | Policies naming G0001 | |
| J0610 | Not listed | Policies naming J0610 | |
| S2900 | Not listed | Policies naming S2900 |
All Anthem Blue Cross and Blue Shield New Hampshire policies · Anthem Blue Cross and Blue Shield New Hampshire prior authorization CPT list