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Anthem Blue Cross Blue Shield of Colorado prior authorization, page 11

CPT code lookup

Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.

Prior authorization codes

Prior authorization codes
CodeDescriptionSource
27138Revision, Total Hip Arthroplasty; Femoral Component Only, W/Wo AllograftColorado Prior Authorization List, Pg 26 Original policy
27275Manipulation, Hip Joint, Requiring General AnesthesiaColorado Prior Authorization List, Pg 26 Original policy
27279Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular dColorado Prior Authorization List, Pg 26 Original policy
27280Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performedColorado Prior Authorization List, Pg 26 Original policy
27331Arthrotomy, Knee; W/Joint Exploration, Bx/Removal, Loose/FbColorado Prior Authorization List, Pg 26 Original policy
27332Arthrotomy, W/Excision, Semilunar Cartilage (Meniscectomy) Knee; Medial/LateralColorado Prior Authorization List, Pg 26 Original policy
27333Arthrotomy, W/Excision, Semilunar Cartilage (Meniscectomy) Knee; Medial & LateralColorado Prior Authorization List, Pg 26 Original policy
27334Arthrotomy, W/Synovectomy Knee; Anterior/PosteriorColorado Prior Authorization List, Pg 26 Original policy
27335Arthrotomy, W/Synovectomy Knee; Anterior & Posterior W/Popliteal AreaColorado Prior Authorization List, Pg 26 Original policy
27345Excision, Synovial Cyst, Popliteal SpaceColorado Prior Authorization List, Pg 26 Original policy
27347Excision, Lesion, Meniscus/Capsule, KneeColorado Prior Authorization List, Pg 26 Original policy
27403Arthrotomy W/Meniscus Repair, KneeColorado Prior Authorization List, Pg 26 Original policy
27405Repair, Primary, Torn Ligament &/Or Capsule, Knee; CollateralColorado Prior Authorization List, Pg 27 Original policy
27407Repair, Primary, Torn Ligament &/Or Capsule, Knee; CruciateColorado Prior Authorization List, Pg 27 Original policy
27409Repair, Primary, Torn Ligament &/Or Capsule, Knee; Collateral & Cruciate LigamentsColorado Prior Authorization List, Pg 27 Original policy
27412Autologous Chondrocyte Implantation, KneeColorado Prior Authorization List, Pg 27 Original policy
27415Rep Ligaments Knee+pes Anserin TranColorado Prior Authorization List, Pg 27 Original policy
27416Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft(s)Colorado Prior Authorization List, Pg 27 Original policy
27425Lateral Retinacular Release OpenColorado Prior Authorization List, Pg 27 Original policy
27427Ligamentous Reconstruction (Augmentation), Knee; Extra-ArticularColorado Prior Authorization List, Pg 27 Original policy
27428Ligamentous Reconstruction (Augmentation), Knee; Intra-Articular, (Open)Colorado Prior Authorization List, Pg 27 Original policy
27429Ligamentous Reconstruction (Augmentation), Knee; Intra-Articular, (Open) & Extra-ArticularColorado Prior Authorization List, Pg 27 Original policy
27437Arthroplasty, Patella; W/O ProsthesisColorado Prior Authorization List, Pg 27 Original policy
27438Arthroplasty, Patella; W/ProsthesisColorado Prior Authorization List, Pg 27 Original policy
27440Arthroplasty, Knee, Tibial PlateauColorado Prior Authorization List, Pg 27 Original policy
27441Arthroplasty, Knee, Tibial Plateau; W/Debridement & Partial SynovectomyColorado Prior Authorization List, Pg 27 Original policy
27442Arthroplasty, Femoral Condyles/Tibial Plateau(S), KneeColorado Prior Authorization List, Pg 28 Original policy
27443Arthroplasty, Femoral Condyles/Tibial Plateau(S), Knee; W/Debridement & Partial SynovectomyColorado Prior Authorization List, Pg 28 Original policy
27446Arthroplasty, Knee, Condyle & Plateau; Medial/Lateral CompartmentColorado Prior Authorization List, Pg 28 Original policy
27447Arthroplasty, Knee, Condyle & Plateau; Medial & Lateral Compartments, W/Wo Patella ResurfacingColorado Prior Authorization List, Pg 28 Original policy
27486Revision, Total Knee Arthroplasty, W/Wo Allograft; 1 ComponentColorado Prior Authorization List, Pg 28 Original policy
27487Revision, Total Knee Arthroplasty; Femoral & Entire Tibial ComponentColorado Prior Authorization List, Pg 28 Original policy
27488Removal, Knee Prosthesis, Methylmethacrylate W/Wo Spacer InsertionColorado Prior Authorization List, Pg 28 Original policy
27570Manipulation, Knee Joint Under General AnesthesiaColorado Prior Authorization List, Pg 28 Original policy
27613Bx, Soft Tissue, Leg/Ankle Area; SuperficialColorado Prior Authorization List, Pg 28 Original policy
27614Bx, Soft Tissue, Leg/Ankle Area; Deep (Subfascial/Im)Colorado Prior Authorization List, Pg 28 Original policy
27618Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cmColorado Prior Authorization List, Pg 28 Original policy
27619Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cmColorado Prior Authorization List, Pg 28 Original policy
27632Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greaterColorado Prior Authorization List, Pg 28 Original policy
27634Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greaterColorado Prior Authorization List, Pg 28 Original policy
27702Arthroplasty, Ankle; W/Implant (Total Ankle)Colorado Prior Authorization List, Pg 28 Original policy
27703Arthroplasty, Ankle; Revision, Total AnkleColorado Prior Authorization List, Pg 28 Original policy
27704Removal, Ankle ImplantColorado Prior Authorization List, Pg 29 Original policy
27860Manipulation, Ankle Under General AnesthesiaColorado Prior Authorization List, Pg 29 Original policy
27870Arthrodesis, Ankle, OpenColorado Prior Authorization List, Pg 29 Original policy
28110Ostectomy, Partial Excision, 5th Metatarsal Head (Bunionette) (Sep Proc)Colorado Prior Authorization List, Pg 29 Original policy
28285Correction, HammertoeColorado Prior Authorization List, Pg 29 Original policy
28286Correction, Cock-Up Fifth Toe, W/Plastic Skin ClosureColorado Prior Authorization List, Pg 29 Original policy
28289Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implantColorado Prior Authorization List, Pg 29 Original policy
28291Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint with implantColorado Prior Authorization List, Pg 29 Original policy

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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