Anthem Blue Cross Blue Shield of California policy
CG-OR-PR-10 Osseointegrated Limb Prostheses
CG-OR-PR-10 Osseointegrated Limb Prostheses is a public Anthem Blue Cross Blue Shield of California policy (policy CG-OR-PR-10). It lists 5 CPT or HCPCS codes, 2 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-OR-PR-10
- 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 |
|---|---|---|---|
| 24999 | Not listed | Policies naming 24999 | |
| 27599 | On the list | Unlisted procedure, femur or knee [when specified as implantation of a medial knee implanted shock absorber] or [when specified as implantation of RETHYMIC into quadriceps muscle] | Policies naming 27599 |
| L5991 | Not listed | Policies naming L5991 | |
| L7499 | Not listed | Policies naming L7499 | |
| L8699 | On the list | Prosthetic implant, not otherwise specified [when specified as hybrid cochlear device, including all internal and external components] or [when describing replacement components of an auditory brain stem implant] or [when specified as a hyaluronic acid gel agent such as Juvederm or Restylane] or [when describing a prefabricated, custom-fitted auricular implant] or [when describing a custom-fabricated auricular implant] or [when specified as testicular or penile prosthesis] | Policies naming L8699 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list