Anthem Blue Cross Blue Shield of California policy
Ambulatory Electroencephalography
Ambulatory Electroencephalography is a public Anthem Blue Cross Blue Shield of California policy (policy CG-MED-46). It lists 22 CPT or HCPCS codes, 12 of them on the Anthem Blue Cross Blue Shield of California prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-MED-46
- 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 Blue Shield of California prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of California policies |
|---|---|---|---|
| 95700 | Not listed | Policies naming 95700 | |
| 95705 | Not listed | Policies naming 95705 | |
| 95706 | Not listed | Policies naming 95706 | |
| 95708 | Not listed | Policies naming 95708 | |
| 95709 | Not listed | Policies naming 95709 | |
| 95711 | On the list | Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; unmonitored | Policies naming 95711 |
| 95712 | On the list | Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with intermittent monitoring and maintenance | Policies naming 95712 |
| 95713 | On the list | Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with continuous, real-time monitoring and maintenance | Policies naming 95713 |
| 95714 | On the list | Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored | Policies naming 95714 |
| 95715 | On the list | Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance | Policies naming 95715 |
| 95716 | On the list | Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance | Policies naming 95716 |
| 95717 | Not listed | Policies naming 95717 | |
| 95718 | On the list | Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of EEG recording; with video (VEEG) | Policies naming 95718 |
| 95719 | Not listed | Policies naming 95719 | |
| 95720 | On the list | Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG) | Policies naming 95720 |
| 95721 | Not listed | Policies naming 95721 | |
| 95722 | On the list | Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of EEG recording, with video (VEEG) | Policies naming 95722 |
| 95723 | Not listed | Policies naming 95723 | |
| 95724 | On the list | Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of EEG recording, with video (VEEG) | Policies naming 95724 |
| 95725 | Not listed | Policies naming 95725 | |
| 95726 | On the list | Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG) | Policies naming 95726 |
| 95999 | On the list | Unlisted neurological or neuromuscular diagnostic procedure [when specified as physiologic recording of tremor using accelerometer(s) and/or gyroscope(s) (including frequency and amplitude), including interpretation and report] or when specified as Sudoscan testing] | Policies naming 95999 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list