Anthem Blue Cross and Blue Shield Virginia policy
Preoperative Testing for Low Risk Invasive Procedures and Surgeries
Preoperative Testing for Low Risk Invasive Procedures and Surgeries is a public Anthem Blue Cross and Blue Shield Virginia policy (policy CG-MED-61). It lists 16 CPT or HCPCS codes, 9 of them on the Anthem Blue Cross and Blue Shield Virginia prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-MED-61
- 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 |
|---|---|---|---|
| 80047 | On the list | Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8256 | Policies naming 80047 |
| 80048 | On the list | Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) G | Policies naming 80048 |
| 85025 | On the list | Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc | Policies naming 85025 |
| 85027 | On the list | Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) | Policies naming 85027 |
| 85610 | On the list | Prothrombin Time | Policies naming 85610 |
| 85730 | On the list | Thromboplastin Time, Partial (Ptt); Plasma/Whole Blood | Policies naming 85730 |
| 93000 | Not listed | Policies naming 93000 | |
| 93005 | Not listed | Policies naming 93005 | |
| 93010 | Not listed | Policies naming 93010 | |
| 93306 | On the list | Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, com | Policies naming 93306 |
| 93307 | On the list | Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, com | Policies naming 93307 |
| 93308 | On the list | Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, fol | Policies naming 93308 |
| 99242 | Not listed | Policies naming 99242 | |
| 99243 | Not listed | Policies naming 99243 | |
| 99244 | Not listed | Policies naming 99244 | |
| 99245 | Not listed | Policies naming 99245 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list