Anthem Blue Cross Blue Shield of California policy
CG-SURG-81 Cochlear Implants and Auditory Brainstem Implants
CG-SURG-81 Cochlear Implants and Auditory Brainstem Implants is a public Anthem Blue Cross Blue Shield of California policy (policy CG-SURG-81). It lists 8 CPT or HCPCS codes, 7 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-SURG-81
- 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 |
|---|---|---|---|
| 69930 | On the list | Cochlear device implantation, with or without mastoidectomy | Policies naming 69930 |
| 69949 | On the list | Unlisted procedure, inner ear [when specified as implantation of hybrid cochlear device] | Policies naming 69949 |
| L8614 | On the list | Cochlear device, includes all internal and external components | Policies naming L8614 |
| L8619 | On the list | Cochlear implant external speech processor, replacement | Policies naming L8619 |
| L8627 | On the list | Cochlear implant, external speech processor, component, replacement | Policies naming L8627 |
| L8628 | On the list | Cochlear implant, external controller component, replacement | Policies naming L8628 |
| 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 |
| S2235 | Not listed | Policies naming S2235 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list