Anthem Blue Cross and Blue Shield Virginia prior authorization, page 38

CPT code lookup

Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.

Prior authorization codes

Prior authorization codes
Code	Description	Source
85547	Mechanical Fragility, Rbc	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85549	Muramidase	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85555	Osmotic Fragility, Rbc; Unincubated	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85557	Osmotic Fragility, Rbc; Incubated	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85576	Platelet, Aggregation (In Vitro), Each Agent	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85597	Phospholipid neutralization; platelet	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85598	Phospholipid neutralization; hexagonal phospholipid	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85610	Prothrombin Time	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85611	Prothrombin Time; Substitution, Plasma Fractions, Each	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85612	Russell Viper Venom Time (Includes Venom); Undiluted	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85613	Russell Viper Venom Time (Includes Venom); Diluted	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85635	Reptilase Test	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85651	Sedimentation Rate, Erythrocyte; Non-Automated	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85652	Sedimentation Rate, Erythrocyte; Automated	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85660	Sickling, Rbc, Reduction	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85670	Thrombin Time; Plasma	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85675	Thrombin Time; Titer	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85705	Thromboplastin Inhibition; Tissue	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85730	Thromboplastin Time, Partial (Ptt); Plasma/Whole Blood	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85732	Thromboplastin Time, Partial (Ptt); Substitution, Plasma Fractions, Each	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
85810	Viscosity	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86000	Agglutinins, Febrile, Each Antigen	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86001	Allergen Specific Igg Quantitative/Semiquantitative, Ea Allergen	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86003	Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86005	Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card)	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86008	Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86021	Antibody Identification; Leukocyte Antibodies	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86022	Antibody Identification; Platelet Antibodies	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86023	Antibody Identification; Platelet Associated Immunoglobulin Assay	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86038	Antinuclear Antibodies (Ana)	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86039	Antinuclear Antibodies (Ana); Titer	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86060	Antistreptolysin 0; Titer	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86063	Antistreptolysin 0; Screen	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86077	Blood Bank Physician Services; Difficult Cross Match &/Or Eval, Interpretation & Written Report	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86078	Blood Bank Physician Services; Investigation, Transfusion Rxn, Interpretation & Written Report	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86079	Blood Bank Physician Services; Authorization, Deviation, Standard Proc W/Written Report	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86140	C-Reactive Protein	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86141	C-Reactive Protein; High Sensitivity (Hscrp)	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86146	Beta 2 Glycoprotein I Antibody, Ea	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86147	Cardiolipin (Phospholipid) Antibody, Ea Ig Class	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86148	Anti-Phosphatidylserine (Phospholipid) Antibody	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86152	Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood)	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86153	Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86155	Chemotaxis Assay, Specify Method	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86156	Cold Agglutinin; Screen	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86157	Cold Agglutinin; Titer	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86160	Complement; Antigen, Each Component	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86161	Complement; Functional Activity, Each Component	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86162	Complement; Total Hemolytic (Ch50)	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy
86171	Complement Fixation Tests, Each Antigen	Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 46 Original policy

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.