Anthem Blue Cross and Blue Shield Virginia policy
SURG.00142 Genicular Procedures for Treatment of Knee Pain
SURG.00142 Genicular Procedures for Treatment of Knee Pain is a public Anthem Blue Cross and Blue Shield Virginia policy (policy SURG.00142). It lists 7 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
- SURG.00142
- 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 |
|---|---|---|---|
| 00011 | Not listed | Policies naming 00011 | |
| 00140 | Not listed | Policies naming 00140 | |
| 00142 | Not listed | Policies naming 00142 | |
| 00155 | Not listed | Policies naming 00155 | |
| 64454 | On the list | Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed | Policies naming 64454 |
| 64624 | On the list | Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed | Policies naming 64624 |
| 64999 | Not listed | Policies naming 64999 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list