Anthem Blue Cross Blue Shield of California policy
Anthem Centers of Medical Excellence (CME) Transplant Network Contract Operations Manual for Transplant Program
Anthem Centers of Medical Excellence (CME) Transplant Network Contract Operations Manual for Transplant Program is a public Anthem Blue Cross Blue Shield of California policy (effective Jan 1, 2020). It lists 10 CPT or HCPCS codes, 10 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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- Effective
- Jan 1, 2020
- Line of business
- Commercial, Medicaid
- States
- CA
- 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 |
|---|---|---|---|
| 32851 | On the list | Lung transplant, single; without cardiopulmonary bypass | Policies naming 32851 |
| 33945 | On the list | Heart transplant, with or without recipient cardiectomy | Policies naming 33945 |
| 38205 | On the list | Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic | Policies naming 38205 |
| 38206 | On the list | Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous | Policies naming 38206 |
| 38232 | On the list | Bone marrow harvesting for transplantation; autologous | Policies naming 38232 |
| 38240 | On the list | Bone marrow or blood-derived peripheral stem cell transplantation; allogeneic transplantation per donor | Policies naming 38240 |
| 38241 | On the list | Hematopoietic progenitor cell (HPC); autologous transplantation | Policies naming 38241 |
| 47135 | On the list | Liver allotransplantation; orthotopic, partial or whole, from cadaver or living donor, any age | Policies naming 47135 |
| 48554 | On the list | Transplantation of pancreatic allograft | Policies naming 48554 |
| 50360 | On the list | Renal allotransplantation, implantation of graft; without recipient nephrectomy | Policies naming 50360 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list