Anthem Blue Cross Blue Shield of Colorado prior authorization, page 20
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
| Code | Description | Source |
|---|---|---|
| 44135 | Intestinal Allotransplantation; From Cadaver Donor | Colorado Prior Authorization List, Pg 51 Original policy |
| 44136 | Intestinal Allotransplantation; From Living Donor | Colorado Prior Authorization List, Pg 51 Original policy |
| 44340 | Revision, Colostomy; Simple (Release, Superficial Scar) (Sep Proc) | Colorado Prior Authorization List, Pg 51 Original policy |
| 44360 | Small Intestinal Endo/Enteroscopy, > 2nd Portion Duodenum, Not W/Ileum; Dx W/Wo Specimen (Sep Proc) | Colorado Prior Authorization List, Pg 51 Original policy |
| 44361 | Small Intestinal Endo/Enteroscopy, > 2nd Portion Duodenum, Not W/Ileum; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 51 Original policy |
| 44364 | Small Intestinal Endo/Enteroscopy > 2nd Portion Duodenum, Not W/Ileum; W/Removal, Lesion, Snare | Colorado Prior Authorization List, Pg 51 Original policy |
| 44369 | Small Intestinal Endo/Enteroscopy > 2nd Portion Duodenum, Not W/Ileum; W/ Other Ablation, Lesion | Colorado Prior Authorization List, Pg 51 Original policy |
| 44376 | Small Intestinal Endo/Enteroscopy > 2nd Portion Duodenum, W/Ileum; Dx W/Wo Specimen (Sep Proc) | Colorado Prior Authorization List, Pg 51 Original policy |
| 44377 | Small Intestinal Endo/Enteroscopy > 2nd Portion Duodenum, W/Ileum; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 51 Original policy |
| 44380 | Ileoscopy, Through Stoma; Dx (Sep Proc) | Colorado Prior Authorization List, Pg 51 Original policy |
| 44381 | Ileoscopy, through stoma; with transendoscopic balloon dilation | Colorado Prior Authorization List, Pg 51 Original policy |
| 44382 | Ileoscopy, Through Stoma; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 51 Original policy |
| 44385 | Endoscopic Eval, Small Intestinal Pouch; Dx, W/Wo Specimen(S), Brushing/Washing (Sep Proc) | Colorado Prior Authorization List, Pg 51 Original policy |
| 44386 | Endoscopic Eval, Small Intestinal Pouch; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 51 Original policy |
| 44388 | Colonoscopy Through Stoma; Dx W/Wo Specimens, Brushing/Washing (Sep Proc) | Colorado Prior Authorization List, Pg 51 Original policy |
| 44389 | Colonoscopy Through Stoma; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 51 Original policy |
| 44392 | Colonoscopy Through Stoma; W/Removal, Lesion, Hot Forceps/Cautery | Colorado Prior Authorization List, Pg 51 Original policy |
| 44394 | Colonoscopy Through Stoma; W/Removal, Lesion, Snare | Colorado Prior Authorization List, Pg 51 Original policy |
| 44705 | Preparation of fecal microbiota for instillation, including assessment of donor specimen | Colorado Prior Authorization List, Pg 51 Original policy |
| 44715 | Backbench Standard Preparation Of Cadaver Or Living Donor Intestine Allograft | Colorado Prior Authorization List, Pg 51 Original policy |
| 44720 | Backbench Reconstruction Of Cadaver Or Living Donor Intestine Allograft; Venous Anastomosis, Each | Colorado Prior Authorization List, Pg 51 Original policy |
| 44721 | Backbench Reconstruction Of Cadaver Or Living Donor Intestine Allograft; Arterial Anastomosis, Each | Colorado Prior Authorization List, Pg 51 Original policy |
| 45100 | Bx, Anorectal Wall, Anal Approach | Colorado Prior Authorization List, Pg 51 Original policy |
| 45171 | Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness) | Colorado Prior Authorization List, Pg 51 Original policy |
| 45172 | Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness) | Colorado Prior Authorization List, Pg 51 Original policy |
| 45190 | Destruction, Rectal Tumor, Transanal Approach | Colorado Prior Authorization List, Pg 51 Original policy |
| 45305 | Proctosigmoidoscopy, Rigid; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 51 Original policy |
| 45330 | Sigmoidoscopy, Flexible; Dx, W/Wo Specimens, Brushing/Washing (Sep Proc) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45331 | Sigmoidoscopy, Flexible; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 52 Original policy |
| 45334 | Sigmoidoscopy, Flexible; W/Control, Bleeding | Colorado Prior Authorization List, Pg 52 Original policy |
| 45335 | Sigmoidoscopy, Flexible; W/Directed Submucosal Injection(S), Any Substance | Colorado Prior Authorization List, Pg 52 Original policy |
| 45340 | Sigmoidoscopy, Flexible; W/Dilation, Balloon, 1/> Strictures | Colorado Prior Authorization List, Pg 52 Original policy |
| 45341 | Sigmoidoscopy, Flexible; W/Endoscopic Ultrasound Exam | Colorado Prior Authorization List, Pg 52 Original policy |
| 45342 | Sigmoidoscopy, Flexible; W/Transendoscopic Ultrasound Guided Intra- /Transmural Fine Needle Aspir/Bx | Colorado Prior Authorization List, Pg 52 Original policy |
| 45346 | Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45349 | Sigmoidoscopy, flexible; with endoscopic mucosal resection | Colorado Prior Authorization List, Pg 52 Original policy |
| 45350 | Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45378 | Colonoscopy, Flexible, Proximal To Splenic Flexure; Dx, W/Wo Specimens/Colon Decomp (Sep Proc) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45379 | Colonoscopy, Flexible, Proximal To Splenic Flexure; W/Removal, Fb | Colorado Prior Authorization List, Pg 52 Original policy |
| 45380 | Colonoscopy, Flexible, Proximal To Splenic Flexure; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 52 Original policy |
| 45381 | Colonoscpy, Flexible, Proximal To Splenic Flexure; W/Directed Submucosa Injection(S), Any Substance | Colorado Prior Authorization List, Pg 52 Original policy |
| 45384 | Colonoscopy, Flexible; W/Removal, Lesion, Hot Forceps/Cautery | Colorado Prior Authorization List, Pg 52 Original policy |
| 45385 | Colonoscopy, Flexible; W/Removal, Lesion, Snare | Colorado Prior Authorization List, Pg 52 Original policy |
| 45386 | Colonoscopy, Flexible, Proximal To Splenic Flexure; W/Dilation, Balloon, 1/> Strictures | Colorado Prior Authorization List, Pg 52 Original policy |
| 45388 | Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45389 | Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post- dilation and guide wire passage, when performed) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45390 | Colonoscopy, flexible; with endoscopic mucosal resection | Colorado Prior Authorization List, Pg 52 Original policy |
| 45391 | Colonoscopy, Flexible, Proximal To Splenic Flexure; With Endoscopic Ultrasound Examination | Colorado Prior Authorization List, Pg 52 Original policy |
| 45398 | Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45505 | Proctoplasty; Prolapse, Mucous Membrane | Colorado Prior Authorization List, Pg 52 Original policy |