Anthem Blue Cross Blue Shield of Colorado policy
SURG.00113 Artificial Retinal Devices
SURG.00113 Artificial Retinal Devices is a public Anthem Blue Cross Blue Shield of Colorado policy (policy SURG.00113). It lists 4 CPT or HCPCS codes, 3 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
- SURG.00113
- 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 |
|---|---|---|---|
| 0100T | On the list | Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy | Policies naming 0100T |
| 0472T | On the list | Device evaluation, interrogation, and initial programming of intra- ocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implan | Policies naming 0472T |
| 0473T | On the list | Device evaluation and interrogation of intra-ocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, w | Policies naming 0473T |
| L8608 | Not listed | Policies naming L8608 |
All Anthem Blue Cross Blue Shield of Colorado policies · Anthem Blue Cross Blue Shield of Colorado prior authorization CPT list