Anthem Blue Cross Blue Shield of California policy
SURG.00132 Drug-Eluting Devices for Maintaining Sinus Ostial Patency
SURG.00132 Drug-Eluting Devices for Maintaining Sinus Ostial Patency is a public Anthem Blue Cross Blue Shield of California policy (policy SURG.00132). It lists 3 CPT or HCPCS codes, 3 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.00132
- 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 |
|---|---|---|---|
| 31299 | On the list | Unlisted procedure, accessory sinuses [when specified as application of self-expanding absorptive sinus ostial dilator (for example, SinuSys Vent-OS Sinus Dilation System)] or [when specified as insertion of a drug-eluting sinus stent] | Policies naming 31299 |
| J7402 | On the list | Mometasone furoate sinus implant, (SINUVA), 10 micrograms | Policies naming J7402 |
| S1091 | On the list | Stent, non-coronary, temporary, with delivery system (Propel) | Policies naming S1091 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list