Anthem Blue Cross Blue Shield of Colorado policy
CG-SURG-77 Refractive Surgery
CG-SURG-77 Refractive Surgery is a public Anthem Blue Cross Blue Shield of Colorado policy (policy CG-SURG-77). It lists 29 CPT or HCPCS codes, 6 of them on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-SURG-77
- 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 Colorado prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of Colorado policies |
|---|---|---|---|
| 00001 | Not listed | Policies naming 00001 | |
| 00012 | Not listed | Policies naming 00012 | |
| 00015 | Not listed | Policies naming 00015 | |
| 65760 | Not listed | Policies naming 65760 | |
| 65765 | Not listed | Policies naming 65765 | |
| 65767 | Not listed | Policies naming 65767 | |
| 65771 | Not listed | Policies naming 65771 | |
| 65772 | Not listed | Policies naming 65772 | |
| 65775 | Not listed | Policies naming 65775 | |
| 65785 | Not listed | Policies naming 65785 | |
| 66840 | On the list | Removal of lens material; aspiration technique, 1 or more stages | Policies naming 66840 |
| 66850 | On the list | Removal, Lens Material; Phacofragmentation, W/Aspiration | Policies naming 66850 |
| 66852 | On the list | Removal, Lens Material; Pars Plana Approach, W/Wo Vitrectomy | Policies naming 66852 |
| 66920 | Not listed | Policies naming 66920 | |
| 66930 | Not listed | Policies naming 66930 | |
| 66940 | Not listed | Policies naming 66940 | |
| 66985 | On the list | Insertion, Intraocular Lens Prosthesis (Secondary Implant) (No Concurrent Cataract Removal) | Policies naming 66985 |
| 66999 | Not listed | Policies naming 66999 | |
| C1780 | Not listed | Policies naming C1780 | |
| Q1004 | Not listed | Policies naming Q1004 | |
| Q1005 | Not listed | Policies naming Q1005 | |
| S0596 | Not listed | Policies naming S0596 | |
| S0800 | Not listed | Policies naming S0800 | |
| S0810 | Not listed | Policies naming S0810 | |
| V2630 | Not listed | Policies naming V2630 | |
| V2631 | Not listed | Policies naming V2631 | |
| V2632 | Not listed | Policies naming V2632 | |
| V2787 | On the list | Astigmatism correcting function of intraocular lens | Policies naming V2787 |
| V2788 | On the list | Presbyopia correcting function of intraocular lens | Policies naming V2788 |
All Anthem Blue Cross Blue Shield of Colorado policies · Anthem Blue Cross Blue Shield of Colorado prior authorization CPT list