Anthem Blue Cross and Blue Shield Virginia policy
LAB.00045 Selected Tests for the Evaluation and Management of Infertility
LAB.00045 Selected Tests for the Evaluation and Management of Infertility is a public Anthem Blue Cross and Blue Shield Virginia policy (policy LAB.00045). It lists 5 CPT or HCPCS codes, 4 of them on the Anthem Blue Cross and Blue Shield Virginia prior authorization list. Not a coverage decision; the payer's own document governs.
Check eligibility for free
No account required. Sign a BAA to see plan details, coordination of benefits and more
- Policy number
- LAB.00045
- 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 |
|---|---|---|---|
| 0255U | On the list | Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of c | Policies naming 0255U |
| 86357 | On the list | Natural killer (NK) cells, total count | Policies naming 86357 |
| 89329 | On the list | Sperm Evaluation; Hamster Penetration Test | Policies naming 89329 |
| 89330 | On the list | Sperm Evaluation; Cervical Mucus Penetration Test, W/Wo Spinnbarkeit Test | Policies naming 89330 |
| 89398 | Not listed | Policies naming 89398 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list