Anthem Blue Cross and Blue Shield Virginia policy
DME.00048 Virtual Reality-Assisted Therapy Systems
DME.00048 Virtual Reality-Assisted Therapy Systems is a public Anthem Blue Cross and Blue Shield Virginia policy (policy DME.00048). It lists 7 CPT or HCPCS codes, 6 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
- DME.00048
- 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 |
|---|---|---|---|
| 0770T | On the list | Virtual reality technology to assist therapy (List separately in addition to code for primary procedure) | Policies naming 0770T |
| 0771T | On the list | Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi | Policies naming 0771T |
| 0772T | On the list | Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi | Policies naming 0772T |
| 0773T | On the list | Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca | Policies naming 0773T |
| 0774T | On the list | Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca | Policies naming 0774T |
| E1399 | Not listed | Policies naming E1399 | |
| E1905 | On the list | Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software | Policies naming E1905 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list