Anthem Blue Cross Blue Shield of Colorado prior authorization, page 21
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 |
|---|---|---|
| 45541 | Proctopexy (eg, for prolapse); perineal approach | Colorado Prior Authorization List, Pg 52 Original policy |
| 45560 | Repair, Rectocele (Sep Proc) | Colorado Prior Authorization List, Pg 52 Original policy |
| 45905 | Dilation, Anal Sphincter (Sep Proc) Under Anesthesia Other Than Local | Colorado Prior Authorization List, Pg 52 Original policy |
| 45910 | Dilation, Rectal Stricture (Sep Proc) Under Anesthesia Other Than Local | Colorado Prior Authorization List, Pg 52 Original policy |
| 45915 | Removal, Fecal Impaction/Fb (Sep Proc) Under Anesthesia | Colorado Prior Authorization List, Pg 52 Original policy |
| 45990 | Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic | Colorado Prior Authorization List, Pg 52 Original policy |
| 46020 | Placement, Seton | Colorado Prior Authorization List, Pg 52 Original policy |
| 46030 | Removal, Anal Seton, Other Marker | Colorado Prior Authorization List, Pg 52 Original policy |
| 46040 | Incision & Drainage, Ischiorectal &/Or Perirectal Abscess (Sep Proc) | Colorado Prior Authorization List, Pg 53 Original policy |
| 46045 | Incision & Drainage, Intramural/Intramuscular/Submucosal Abscess, Transanal, W/Anesthesia | Colorado Prior Authorization List, Pg 53 Original policy |
| 46050 | Incision & Drainage, Perianal Abscess, Superficial | Colorado Prior Authorization List, Pg 53 Original policy |
| 46060 | Incision & Drainage, Ischiorectal/Intramural Abscess, W/Fistulectomy/Otomy,Submuscular W/Wo Seton | Colorado Prior Authorization List, Pg 53 Original policy |
| 46080 | Sphincterotomy, Anal, Division, Sphincter (Sep Proc) | Colorado Prior Authorization List, Pg 53 Original policy |
| 46083 | Incision, Thrombosed Hemorrhoid, Ext | Colorado Prior Authorization List, Pg 53 Original policy |
| 46200 | Fissurectomy, including sphincterotomy, when performed | Colorado Prior Authorization List, Pg 53 Original policy |
| 46220 | Excision of single external papilla or tag, anus | Colorado Prior Authorization List, Pg 53 Original policy |
| 46221 | Hemorrhoidectomy, internal, by rubber band ligation(s) | Colorado Prior Authorization List, Pg 53 Original policy |
| 46230 | Excision of multiple external papillae or tags, anus | Colorado Prior Authorization List, Pg 53 Original policy |
| 46250 | Hemorrhoidectomy, external, 2 or more columns/groups | Colorado Prior Authorization List, Pg 53 Original policy |
| 46255 | Hemorrhoidectomy, internal and external, single column/group | Colorado Prior Authorization List, Pg 53 Original policy |
| 46257 | Hemorrhoidectomy, internal and external, single column/group; with fissurectomy | Colorado Prior Authorization List, Pg 53 Original policy |
| 46258 | Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed | Colorado Prior Authorization List, Pg 53 Original policy |
| 46260 | Hemorrhoidectomy, internal and external, 2 or more columns/groups | Colorado Prior Authorization List, Pg 53 Original policy |
| 46261 | Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy | Colorado Prior Authorization List, Pg 53 Original policy |
| 46262 | Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when perfo | Colorado Prior Authorization List, Pg 53 Original policy |
| 46270 | Surgical Treatment, Anal Fistula (Fistulectomy/Fistulotomy); Subq | Colorado Prior Authorization List, Pg 53 Original policy |
| 46275 | Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric | Colorado Prior Authorization List, Pg 53 Original policy |
| 46280 | Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or m | Colorado Prior Authorization List, Pg 53 Original policy |
| 46285 | Surgical Treatment, Anal Fistula (Fistulectomy/Fistulotomy); 2nd Stage | Colorado Prior Authorization List, Pg 53 Original policy |
| 46288 | Closure, Anal Fistula W/Rectal Advancement Flap | Colorado Prior Authorization List, Pg 53 Original policy |
| 46320 | Excision of thrombosed hemorrhoid, external | Colorado Prior Authorization List, Pg 53 Original policy |
| 46505 | Chemodenervation of internal anal sphincter | Colorado Prior Authorization List, Pg 53 Original policy |
| 46606 | Anoscopy; W/Bx, Single/Multiple | Colorado Prior Authorization List, Pg 53 Original policy |
| 46610 | Anoscopy; W/Removal, Single Lesion, Hot Forceps/Cautery | Colorado Prior Authorization List, Pg 53 Original policy |
| 46612 | Anoscopy; W/Removal, Multiple Lesions, Hot Forceps/Cautery/Snare | Colorado Prior Authorization List, Pg 53 Original policy |
| 46615 | Anoscopy; W/Ablation, Lesion, Not Removed By Hot Forceps/Cautery/Snare | Colorado Prior Authorization List, Pg 53 Original policy |
| 46700 | Anoplasty, Plastic Operation, Stricture; Adult | Colorado Prior Authorization List, Pg 53 Original policy |
| 46706 | Repair Of Anal Fistula W/Fibrin Glue | Colorado Prior Authorization List, Pg 53 Original policy |
| 46707 | Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [SIS]) | Colorado Prior Authorization List, Pg 53 Original policy |
| 46750 | Sphincteroplasty, Anal, Incontinence/Prolapse; Adult | Colorado Prior Authorization List, Pg 53 Original policy |
| 46910 | Destruction, Anal Lesion(S), Simple; Electrodesiccation | Colorado Prior Authorization List, Pg 53 Original policy |
| 46917 | Destruction, Anal Lesion(S), Simple; Laser Surgery | Colorado Prior Authorization List, Pg 54 Original policy |
| 46922 | Destruction, Anal Lesion(S), Simple; Surgical Excision | Colorado Prior Authorization List, Pg 54 Original policy |
| 46924 | Destruction, Anal Lesion(S), Extensive | Colorado Prior Authorization List, Pg 54 Original policy |
| 46930 | Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) | Colorado Prior Authorization List, Pg 54 Original policy |
| 46940 | Curettage/Cautery, Anal Fissure W/Dilation Sphincter (Sep Proc); Initial | Colorado Prior Authorization List, Pg 54 Original policy |
| 46945 | Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance | Colorado Prior Authorization List, Pg 54 Original policy |
| 46946 | Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance | Colorado Prior Authorization List, Pg 54 Original policy |
| 46947 | Hemorrhoidopexy (Eg, For Prolapsing Internal Hemorrhoids) By Stapling | Colorado Prior Authorization List, Pg 54 Original policy |
| 46948 | Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed | Colorado Prior Authorization List, Pg 54 Original policy |