Anthem Blue Cross and Blue Shield Virginia policy
CG-SURG-73 Balloon Sinus Ostial Dilation
CG-SURG-73 Balloon Sinus Ostial Dilation is a public Anthem Blue Cross and Blue Shield Virginia policy (policy CG-SURG-73). It lists 5 CPT or HCPCS codes, 5 of them on the Anthem Blue Cross and Blue Shield Virginia prior authorization list. Not a coverage decision; the payer's own document governs.
- Policy number
- CG-SURG-73
- Line of business
- Commercial
- 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 Virginia prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield Virginia policies |
|---|---|---|---|
| 31295 | On the list | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa | Policies naming 31295 |
| 31296 | On the list | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium | Policies naming 31296 |
| 31297 | On the list | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium | Policies naming 31297 |
| 31298 | On the list | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia | Policies naming 31298 |
| C1726 | On the list | Catheter, balloon dilatation, nonvascular | Policies naming C1726 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list