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Anthem Blue Cross and Blue Shield Virginia prior authorization, page 44

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
87206Smear, Prime Srce, W/Interpr; Fluoresc &/Or Acid Fast Stain, Bacteria/Fungi/Parasit/Virus/Cell TypeVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87207Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87209Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasitesVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87210Smear, Primary Source W/Interpretation; Wet Mount, For Infectious AgentsVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87220Tissue Exam By Koh Slide Of Samples From Skin/Hair/Nails, Fungi/Ectoparasite Ova/MitesVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87230Toxin/Antitoxin Assay, Tissue CultureVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87250Virus Isolation; Inoculation Eggs/Small Animal, Observation & DissectionVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87252Virus Isolation; Tissue Culture Inoculation, Observation & Presumptive Id By Cytopathic EffectVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87253Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolateVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87254Virus Isolation; Centrifuge Enhanced (Shell Vial) Technq, W/Id W/Immunofluor Stain, Ea VirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87255Virus Isolation; Id, Non-Immunologic Method, Other Than Cytopathic EffectVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87260Infectious Agent Antigen Detection By Immunofluorescent Technique; AdenovirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87265Infectious Agent Antigen Detection, Immunofluorescent Technique; Bordetella Pertussis/ParapertussisVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87267Infectious Agent Antigen Detection By Immunofluorescent Technique; Enterovirus, (Dfa)Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87269Infectious Agent Antigen Detection By Immunofluorescent Technique; GiardiaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87270Infectious Agent Antigen Detection By Immunofluorescent Technique; Chlamydia TrachomatisVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87271Infectious Agent Antigen Detection By Immunofluorescent Technique; Cytomegalovirus, (Dfa)Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87272Infectious Agent Antigen Detection By Immunofluorescent Technique; CryptosporidiumVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87273Infectious Agent Antigen Detection By Immunofluorescent Technique; Herpes Simplex Virus Type 2Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87274Infectious Agent Antigen Detection By Immunofluorescent Technique; Herpes Simplex Virus Type IVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87275Infectious Agent Antigen Detection By Immunofluorescent Technique; Influenza B VirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87276Infectious Agent Antigen Detection By Immunofluorescent Technique; Influenza A VirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87278Infectious Agent Antigen Detection By Immunofluorescent Technique; Legionella PneumophilaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87279Infectious Agent Antigen Detection By Immunofluorescent Technique; Parainfluenza Virus, Ea TypeVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87280Infectious Agent Antigen Detection By Immunofluorescent Technique; RsvVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87281Infectious Agent Antigen Detection By Immunofluorescent Technique; Pneumocystis CariniiVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87283Infectious Agent Antigen Detection By Immunofluorescent Technique; RubeolaVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87285Infectious Agent Antigen Detection By Immunofluorescent Technique; Treponema PallidumVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87290Infectious Agent Antigen Detection By Immunofluorescent Technique; Varicella Zoster VirusVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87299Infectious Agent Antigen Detection By Immunofluorescent Technique; Nos, Ea OrganismVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 51 Original policy
87300Immunofluorescent Technique, Polyvalent For Multiple Organsms, Ea Polyvalent AntiserumVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87301Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87305Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87320Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87324Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87327Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87328Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87329Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87332Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87335Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87336Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87337Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87338Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87339Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87340Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87341Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87350Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87380Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87385Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 Original policy
87389Infectious agent antigen detection by immunoassay technique, (eg, enzyVirginia HMO/EPO standard precertification/prior authorization requirements, Pg 52 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.

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