Anthem Blue Cross Blue Shield of California policy

HEDIS ECDS Coding Booklet 2024 - Medicare

HEDIS ECDS Coding Booklet 2024 - Medicare is a public Anthem Blue Cross Blue Shield of California policy (policy CABC-CR-048494-23-CPN48308). It lists 466 CPT or HCPCS codes, 13 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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Payer
Anthem Blue Cross Blue Shield of California
Policy number
CABC-CR-048494-23-CPN48308
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.

CodePrior authorizationDescription on the prior authorization listOther Anthem Blue Cross Blue Shield of California policies
10450Not listedPolicies naming 10450
10524Not listedPolicies naming 10524
12503Not listedPolicies naming 12503
12504Not listedPolicies naming 12504
12773Not listedPolicies naming 12773
13457Not listedPolicies naming 13457
14563Not listedPolicies naming 14563
14564Not listedPolicies naming 14564
14565Not listedPolicies naming 14565
17037Not listedPolicies naming 17037
17855Not listedPolicies naming 17855
17856Not listedPolicies naming 17856
17865Not listedPolicies naming 17865
18261Not listedPolicies naming 18261
18262Not listedPolicies naming 18262
18500Not listedPolicies naming 18500
19762Not listedPolicies naming 19762
19764Not listedPolicies naming 19764
19765Not listedPolicies naming 19765
19766Not listedPolicies naming 19766
19774Not listedPolicies naming 19774
20436Not listedPolicies naming 20436
20437Not listedPolicies naming 20437
20438Not listedPolicies naming 20438
20440Not listedPolicies naming 20440
21440Not listedPolicies naming 21440
24604Not listedPolicies naming 24604
24605Not listedPolicies naming 24605
24606Not listedPolicies naming 24606
24610Not listedPolicies naming 24610
26175Not listedPolicies naming 26175
26176Not listedPolicies naming 26176
26177Not listedPolicies naming 26177
26287Not listedPolicies naming 26287
26289Not listedPolicies naming 26289
26291Not listedPolicies naming 26291
26346Not listedPolicies naming 26346
26347Not listedPolicies naming 26347
26348Not listedPolicies naming 26348
26349Not listedPolicies naming 26349
26350Not listedPolicies naming 26350
26351Not listedPolicies naming 26351
26554Not listedPolicies naming 26554
27396Not listedPolicies naming 27396
27401Not listedPolicies naming 27401
27925Not listedPolicies naming 27925
27926Not listedPolicies naming 27926
29771Not listedPolicies naming 29771
30167Not listedPolicies naming 30167
3044FNot listedPolicies naming 3044F
3046FNot listedPolicies naming 3046F
3048FNot listedPolicies naming 3048F
3049FNot listedPolicies naming 3049F
3050FNot listedPolicies naming 3050F
3051FNot listedPolicies naming 3051F
3052FNot listedPolicies naming 3052F
33717Not listedPolicies naming 33717
36319Not listedPolicies naming 36319
36625Not listedPolicies naming 36625
36626Not listedPolicies naming 36626
36627Not listedPolicies naming 36627
36642Not listedPolicies naming 36642
36962Not listedPolicies naming 36962
37005Not listedPolicies naming 37005
37006Not listedPolicies naming 37006
37016Not listedPolicies naming 37016
37017Not listedPolicies naming 37017
37028Not listedPolicies naming 37028
37029Not listedPolicies naming 37029
37030Not listedPolicies naming 37030
37037Not listedPolicies naming 37037
37038Not listedPolicies naming 37038
37052Not listedPolicies naming 37052
37053Not listedPolicies naming 37053
37539Not listedPolicies naming 37539
37542Not listedPolicies naming 37542
37543Not listedPolicies naming 37543
37551Not listedPolicies naming 37551
37552Not listedPolicies naming 37552
37553Not listedPolicies naming 37553
37554Not listedPolicies naming 37554
37768Not listedPolicies naming 37768
37769Not listedPolicies naming 37769
37770Not listedPolicies naming 37770
37771Not listedPolicies naming 37771
37772Not listedPolicies naming 37772
37773Not listedPolicies naming 37773
37774Not listedPolicies naming 37774
37775Not listedPolicies naming 37775
38070Not listedPolicies naming 38070
38071Not listedPolicies naming 38071
38072Not listedPolicies naming 38072
38090Not listedPolicies naming 38090
38091Not listedPolicies naming 38091
38372Not listedPolicies naming 38372
38807Not listedPolicies naming 38807
38820Not listedPolicies naming 38820
38854Not listedPolicies naming 38854
38855Not listedPolicies naming 38855
39150Not listedPolicies naming 39150
39152Not listedPolicies naming 39152
39153Not listedPolicies naming 39153
39154Not listedPolicies naming 39154
41024Not listedPolicies naming 41024
42168Not listedPolicies naming 42168
42169Not listedPolicies naming 42169
42174Not listedPolicies naming 42174
42415Not listedPolicies naming 42415
42416Not listedPolicies naming 42416
44261Not listedPolicies naming 44261
44388Not listedPolicies naming 44388
44389Not listedPolicies naming 44389
44390Not listedPolicies naming 44390
44391Not listedPolicies naming 44391
44392Not listedPolicies naming 44392
44394Not listedPolicies naming 44394
44401Not listedPolicies naming 44401
44402Not listedPolicies naming 44402
44403Not listedPolicies naming 44403
44404Not listedPolicies naming 44404
44405Not listedPolicies naming 44405
44406Not listedPolicies naming 44406
44407Not listedPolicies naming 44407
44408Not listedPolicies naming 44408
45330Not listedPolicies naming 45330
45331Not listedPolicies naming 45331
45332Not listedPolicies naming 45332
45333Not listedPolicies naming 45333
45334Not listedPolicies naming 45334
45335Not listedPolicies naming 45335
45337Not listedPolicies naming 45337
45338Not listedPolicies naming 45338
45340Not listedPolicies naming 45340
45341Not listedPolicies naming 45341
45342Not listedPolicies naming 45342
45346Not listedPolicies naming 45346
45347Not listedPolicies naming 45347
45349Not listedPolicies naming 45349
45350Not listedPolicies naming 45350
45378On the listColonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)Policies naming 45378
45379Not listedPolicies naming 45379
45380On the listColonoscopy, flexible; with biopsy, single or multiplePolicies naming 45380
45381Not listedPolicies naming 45381
45382Not listedPolicies naming 45382
45384On the listColonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forcepsPolicies naming 45384
45385On the listColonoscopy, flexible; with removal of tumor(s), polyps(s), or other lesion(s) by snare techniquePolicies naming 45385
45386Not listedPolicies naming 45386
45388On the listColonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)Policies naming 45388
45389Not listedPolicies naming 45389
45390Not listedPolicies naming 45390
45391Not listedPolicies naming 45391
45392Not listedPolicies naming 45392
45393Not listedPolicies naming 45393
45398Not listedPolicies naming 45398
46335Not listedPolicies naming 46335
46336Not listedPolicies naming 46336
46337Not listedPolicies naming 46337
46338Not listedPolicies naming 46338
46339Not listedPolicies naming 46339
46342Not listedPolicies naming 46342
46350Not listedPolicies naming 46350
46351Not listedPolicies naming 46351
46354Not listedPolicies naming 46354
46355Not listedPolicies naming 46355
46356Not listedPolicies naming 46356
46380Not listedPolicies naming 46380
47527Not listedPolicies naming 47527
47528Not listedPolicies naming 47528
48475Not listedPolicies naming 48475
48492Not listedPolicies naming 48492
48544Not listedPolicies naming 48544
48545Not listedPolicies naming 48545
49132Not listedPolicies naming 49132
49134Not listedPolicies naming 49134
55440Not listedPolicies naming 55440
55758Not listedPolicies naming 55758
56490Not listedPolicies naming 56490
56491Not listedPolicies naming 56491
57905Not listedPolicies naming 57905
58453Not listedPolicies naming 58453
59263Not listedPolicies naming 59263
59264Not listedPolicies naming 59264
59420Not listedPolicies naming 59420
60515Not listedPolicies naming 60515
69002Not listedPolicies naming 69002
69150Not listedPolicies naming 69150
69251Not listedPolicies naming 69251
69259Not listedPolicies naming 69259
71354Not listedPolicies naming 71354
71431Not listedPolicies naming 71431
71777Not listedPolicies naming 71777
71802Not listedPolicies naming 71802
71965Not listedPolicies naming 71965
72137Not listedPolicies naming 72137
72138Not listedPolicies naming 72138
72139Not listedPolicies naming 72139
72140Not listedPolicies naming 72140
72141On the listMRI cervical spine; w/o contrastPolicies naming 72141
72142On the listMRI cervical spine; with contrastPolicies naming 72142
72531Not listedPolicies naming 72531
74261On the listComputed tomographic (CT) colonography, diagnostic, including image post processing; without contrast materialPolicies naming 74261
74262On the listComputed tomographic (CT) colonography, diagnostic, including image post processing; with contrast material(s) including non-contrast images, if performedPolicies naming 74262
74263On the listComputed tomographic (CT) colonography, screening, including image post processingPolicies naming 74263
75624Not listedPolicies naming 75624
75626Not listedPolicies naming 75626
75694Not listedPolicies naming 75694
75889Not listedPolicies naming 75889
77061Not listedPolicies naming 77061
77062Not listedPolicies naming 77062
77063Not listedPolicies naming 77063
77065Not listedPolicies naming 77065
77066Not listedPolicies naming 77066
77067Not listedPolicies naming 77067
77353Not listedPolicies naming 77353
77354Not listedPolicies naming 77354
77379Not listedPolicies naming 77379
77399Not listedPolicies naming 77399
77400Not listedPolicies naming 77400
79069Not listedPolicies naming 79069
79071Not listedPolicies naming 79071
79101On the listRadiopharmaceutical therapy, by intravenous administration [injection of Iobenguane I 131 (Azedra)]Policies naming 79101
80047Not listedPolicies naming 80047
80048Not listedPolicies naming 80048
80050Not listedPolicies naming 80050
80053Not listedPolicies naming 80053
80061Not listedPolicies naming 80061
80069Not listedPolicies naming 80069
80372Not listedPolicies naming 80372
81528Not listedPolicies naming 81528
82270Not listedPolicies naming 82270
82274Not listedPolicies naming 82274
82354Not listedPolicies naming 82354
82456Not listedPolicies naming 82456
82465Not listedPolicies naming 82465
82675Not listedPolicies naming 82675
82688Not listedPolicies naming 82688
82947Not listedPolicies naming 82947
82950Not listedPolicies naming 82950
82951Not listedPolicies naming 82951
83036Not listedPolicies naming 83036
83037Not listedPolicies naming 83037
83700Not listedPolicies naming 83700
83701Not listedPolicies naming 83701
83704Not listedPolicies naming 83704
83718Not listedPolicies naming 83718
83721Not listedPolicies naming 83721
83722Not listedPolicies naming 83722
84478Not listedPolicies naming 84478
86462Not listedPolicies naming 86462
86463Not listedPolicies naming 86463
87624Not listedPolicies naming 87624
87625Not listedPolicies naming 87625
88037Not listedPolicies naming 88037
88122Not listedPolicies naming 88122
88123Not listedPolicies naming 88123
88124Not listedPolicies naming 88124
88141Not listedPolicies naming 88141
88142Not listedPolicies naming 88142
88143Not listedPolicies naming 88143
88147Not listedPolicies naming 88147
88148Not listedPolicies naming 88148
88150Not listedPolicies naming 88150
88152Not listedPolicies naming 88152
88153Not listedPolicies naming 88153
88164Not listedPolicies naming 88164
88165Not listedPolicies naming 88165
88166Not listedPolicies naming 88166
88167Not listedPolicies naming 88167
88174Not listedPolicies naming 88174
88175Not listedPolicies naming 88175
89204Not listedPolicies naming 89204
89205Not listedPolicies naming 89205
89208Not listedPolicies naming 89208
89209Not listedPolicies naming 89209
89569Not listedPolicies naming 89569
90221Not listedPolicies naming 90221
90619Not listedPolicies naming 90619
90630Not listedPolicies naming 90630
90633Not listedPolicies naming 90633
90644Not listedPolicies naming 90644
90647Not listedPolicies naming 90647
90648Not listedPolicies naming 90648
90649Not listedPolicies naming 90649
90650Not listedPolicies naming 90650
90651Not listedPolicies naming 90651
90653Not listedPolicies naming 90653
90654Not listedPolicies naming 90654
90655Not listedPolicies naming 90655
90656Not listedPolicies naming 90656
90657Not listedPolicies naming 90657
90658Not listedPolicies naming 90658
90660Not listedPolicies naming 90660
90661Not listedPolicies naming 90661
90662Not listedPolicies naming 90662
90670Not listedPolicies naming 90670
90671Not listedPolicies naming 90671
90672Not listedPolicies naming 90672
90673Not listedPolicies naming 90673
90674Not listedPolicies naming 90674
90677Not listedPolicies naming 90677

And 166 more in the original policy.

All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.