Anthem Blue Cross Blue Shield of California policy
CG-MED-34 Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures
CG-MED-34 Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures is a public Anthem Blue Cross Blue Shield of California policy (policy CG-MED-34). It lists 5 CPT or HCPCS codes, 5 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-34
- 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 |
|---|---|---|---|
| 00731 | On the list | Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified | Policies naming 00731 |
| 00732 | On the list | Anesthesia for upper gastrointestinal endoscopic procedures; endoscopic retrograde cholangiopancreatography [ERCP] | Policies naming 00732 |
| 00811 | On the list | Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified | Policies naming 00811 |
| 00812 | On the list | Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified; screening colonoscopy | Policies naming 00812 |
| 00813 | On the list | Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum | Policies naming 00813 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list