Anthem Blue Cross and Blue Shield Virginia policy
CG-SURG-88 Mastectomy for Gynecomastia
CG-SURG-88 Mastectomy for Gynecomastia is a public Anthem Blue Cross and Blue Shield Virginia policy (policy CG-SURG-88). It lists 2 CPT or HCPCS codes, 2 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-88
- 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 |
|---|---|---|---|
| 15877 | On the list | Suction Assisted Lipectomy; Trunk | Policies naming 15877 |
| 19300 | On the list | Mastectomy for gynecomastia | Policies naming 19300 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list