Anthem Blue Cross Blue Shield of California policy
Transcatheter Mitral, Pulmonary, and Tricuspid Heart Valve Procedures
Transcatheter Mitral, Pulmonary, and Tricuspid Heart Valve Procedures is a public Anthem Blue Cross Blue Shield of California policy (policy SURG.00121). It lists 15 CPT or HCPCS codes, 15 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.00121
- 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 |
|---|---|---|---|
| 0345T | On the list | Transcatheter mitral valve repair percutaneous approach via the coronary sinus | Policies naming 0345T |
| 0483T | On the list | Transcatheter mitral valve implantation/ replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed | Policies naming 0483T |
| 0484T | On the list | Transcatheter mitral valve implantation/ replacement (TMVI) with prosthetic valve; transthoracic exposure (e.g., thoracotomy, transapical) | Policies naming 0484T |
| 0544T | On the list | Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture | Policies naming 0544T |
| 0545T | On the list | Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device, percutaneous approach | Policies naming 0545T |
| 0569T | On the list | Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis | Policies naming 0569T |
| 0570T | On the list | Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session | Policies naming 0570T |
| 0646T | On the list | Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography, when performed | Policies naming 0646T |
| 33367 | On the list | Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (e.g., femoral vessels) | Policies naming 33367 |
| 33368 | On the list | Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (e.g., femoral, iliac, axillary vessels) | Policies naming 33368 |
| 33369 | On the list | Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (e.g., aorta, right atrium, pulmonary artery) | Policies naming 33369 |
| 33418 | On the list | Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis | Policies naming 33418 |
| 33419 | On the list | Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session | Policies naming 33419 |
| 33477 | On the list | Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed | Policies naming 33477 |
| 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