Anthem Blue Cross Blue Shield of California policy
SURG.00019 Transmyocardial Revascularization
SURG.00019 Transmyocardial Revascularization is a public Anthem Blue Cross Blue Shield of California policy (policy SURG.00019). It lists 3 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
- SURG.00019
- 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 |
|---|---|---|---|
| 33140 | Not listed | Policies naming 33140 | |
| 33141 | On the list | Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) [add- on] | Policies naming 33141 |
| 33999 | On the list | Unlisted procedure, cardiac surgery [when specified as percutaneous transmyocardial revascularization] or [when specified as transmyocardial transcatheter closure of ventricular septal defect, with implant, including cardiopulmonary bypass if performed] or [when specified as transcatheter replacement of tricuspid heart valve] or [when specified as autologous cell therapy for damaged myocardium, including harvesting and preparation of cells] or [when specified as use of a portable normothermic organ perfusion system for heart transplantation] | Policies naming 33999 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list