Talk to Us

Anthem Blue Cross and Blue Shield Virginia prior authorization, page 41

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
CodeDescriptionSource
86696Antibody; Herpes Simplex, Type 2Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86698Antibody; HistoplasmaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86701Antibody; Hiv-1Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86702Antibody; Hiv-2Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86703Antibody; HIV-1 and HIV-2, single resultVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86704Hepatitis B Core Antibody (Hbcab); TotalVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86705Hepatitis B Core Antibody (Hbcab); Igm AntibodyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86706Hepatitis B Surface Antibody (Hbsab)Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86707Hepatitis Be Antibody (Hbeab)Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86708Hepatitis A Antibody (Haab); TotalVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86709Hepatitis A Antibody (Haab); Igm AntibodyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86710Antibody; Influenza VirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 48 Original policy
86711Antibody; JC (John Cunningham) virusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86713Antibody; LegionellaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86717Antibody; LeishmaniaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86720Antibody; LeptospiraVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86723Antibody; Listeria MonocytogenesVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86727Antibody; Lymphocytic ChoriomeningitisVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86732Antibody; MucormycosisVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86735Antibody; MumpsVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86738Antibody; MycoplasmaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86741Antibody; Neisseria MeningitidisVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86744Antibody; NocardiaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86747Antibody; ParvovirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86750Antibody; Plasmodium (Malaria)Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86753Antibody; Protozoa, Not Elsewhere SpecifiedVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86756Antibody; Respiratory Syncytial VirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86757Antibody; RickettsiaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86759Antibody; RotavirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86762Antibody; RubellaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86765Antibody; RubeolaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86768Antibody; SalmonellaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86769Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86771Antibody; ShigellaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86774Antibody; TetanusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86777Antibody; ToxoplasmaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86778Antibody; Toxoplasma, IgmVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86780Antibody; Treponema pallidumVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86784Antibody; TrichinellaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86787Antibody; Varicella-ZosterVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86788Antibody; West Nile virus, IgMVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86789Antibody; West Nile virusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86790Antibody; Virus, Not Elsewhere SpecifiedVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86793Antibody; YersiniaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86794Antibody; Zika virus, IgMVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86800Thyroglobulin AntibodyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86803Hepatitis C AntibodyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86804Hepatitis C Antibody; Confirmatory TestVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86805Lymphocytotoxicity Assay, Visual Crossmatch; W/TitrationVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 Original policy
86806Lymphocytotoxicity Assay, Visual Crossmatch; W/O TitrationVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 49 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.

This website uses cookies to ensure you get the best experience on our website. Learn more