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Anthem Blue Cross Blue Shield of Colorado prior authorization, page 85

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
S2142Cord Blood-Derived Stem-CellColorado Prior Authorization List, Pg 176 Original policy
S2150Bone marrow or blood-derived peripheral stem cell harvesting and transplantation, allogenic or autologous, including pheColorado Prior Authorization List, Pg 176 Original policy
S2202EchosclerotherapyColorado Prior Authorization List, Pg 176 Original policy
S2230Implantation of magnetic component of semi-implantable hearing device on ossicles in middle earColorado Prior Authorization List, Pg 176 Original policy
S2235Implantation of auditory brain stem implantColorado Prior Authorization List, Pg 176 Original policy
S2300Arthroscopy, Shoulder, SurgiColorado Prior Authorization List, Pg 177 Original policy
S2342Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(Colorado Prior Authorization List, Pg 177 Original policy
S2348Decompress disc RF lumbarColorado Prior Authorization List, Pg 177 Original policy
S3800Genetic testing for amyotrophic lateral sclerosis (ALS)Colorado Prior Authorization List, Pg 177 Original policy
S3840DNA analysis for germline mutations of the ret proto-oncogeneColorado Prior Authorization List, Pg 177 Original policy
S3841Genetic testing for retinoblastomaColorado Prior Authorization List, Pg 177 Original policy
S3842Genetic testing for von hippel-lindau diseaseColorado Prior Authorization List, Pg 177 Original policy
S3844DNA analysis of the connexin 26 gene (gjb2) for susceptibility to congenital, profound deafnessColorado Prior Authorization List, Pg 177 Original policy
S3845Genetic testing for alpha-thalassemiaColorado Prior Authorization List, Pg 177 Original policy
S3846Genetic testing for hemoglobin e beta-thalassemiaColorado Prior Authorization List, Pg 177 Original policy
S3849Genetic testing for niemann-pick diseaseColorado Prior Authorization List, Pg 177 Original policy
S3850Genetic testing for sickle cell anemiaColorado Prior Authorization List, Pg 177 Original policy
S3852DNA analysis for apoe epilson 4 allele for susceptibility to Alzheimer's diseaseColorado Prior Authorization List, Pg 177 Original policy
S3853Genetic testing for myotonic muscular dystrophyColorado Prior Authorization List, Pg 177 Original policy
S3854Gene expression profiling panel for use in the management of breast cancer treatmentColorado Prior Authorization List, Pg 177 Original policy
S3861Genetic testing, sodium channel, voltage-gated, Type V, alpha subunit (SCN5A) and variants for suspected brugada syndromColorado Prior Authorization List, Pg 177 Original policy
S3865Comprehensive gene sequence analysis for hypertrophic cardiomyopathyColorado Prior Authorization List, Pg 177 Original policy
S3866Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy (HCM) in an individual with a known HCM muColorado Prior Authorization List, Pg 177 Original policy
S3870Comparative genomic hybridization (cgh) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disabilityColorado Prior Authorization List, Pg 177 Original policy
S3900Surface electromyography (EMG)Colorado Prior Authorization List, Pg 177 Original policy
S8030Scleral application of tantalum ring(s) for localization of lesions for proton beam therapyColorado Prior Authorization List, Pg 177 Original policy
S8035Magnetic Source ImagingColorado Prior Authorization List, Pg 177 Original policy
S8130Interferential current stimulator, 2 channelColorado Prior Authorization List, Pg 177 Original policy
S8131Interferential current stimulator, 4 channelColorado Prior Authorization List, Pg 177 Original policy
S8930Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with patientColorado Prior Authorization List, Pg 177 Original policy
S8940EQUESTRIAN/HIPPOTHERAPY PER SESSIONColorado Prior Authorization List, Pg 177 Original policy
S8948Application of a modality (requiring constant provider attendance) to one orColorado Prior Authorization List, Pg 177 Original policy
S8950Complex Lymphedema TherapyColorado Prior Authorization List, Pg 177 Original policy
S8990Physical or manipulative therapy performed for maintenance rather than restorationColorado Prior Authorization List, Pg 178 Original policy
S9002Intravaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation deviceColorado Prior Authorization List, Pg 178 Original policy
S9056Coma Stimulation Per DiemColorado Prior Authorization List, Pg 178 Original policy
S9090Vertebral Axial DecompressioColorado Prior Authorization List, Pg 178 Original policy
S9123Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when CPT codColorado Prior Authorization List, Pg 178 Original policy
S9124Nursing care, in the home; by licensed practical nurse, per hourColorado Prior Authorization List, Pg 178 Original policy
S9152Speech therapy, re-evaluationColorado Prior Authorization List, Pg 178 Original policy
S9364Home infusion therapy, total parenteral nutrition (TPN) (do not use with home infusion codes S9365-S9368 using daily volColorado Prior Authorization List, Pg 178 Original policy
S9365Home infusion therapy, total parenteral nutrition (TPN); one liter per dayColorado Prior Authorization List, Pg 178 Original policy
S9366Home infusion therapy, total parenteral nutrition (TPN); more than one liter but no more than two liters per dayColorado Prior Authorization List, Pg 178 Original policy
S9367Home infusion therapy, total parenteral nutrition (TPN); more than two liter but no more than three liters per dayColorado Prior Authorization List, Pg 178 Original policy
S9368Home infusion therapy, total parenteral nutrition (TPN); more than three liter per dayColorado Prior Authorization List, Pg 178 Original policy
S9480Intensive Outpatient PsychiaColorado Prior Authorization List, Pg 178 Original policy
S9494Home infusion therapy, antibiotic, antiviral, or antifungal therapy (do not use with home infusion codes for hourly dosiColorado Prior Authorization List, Pg 178 Original policy
S9497Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every three hoursColorado Prior Authorization List, Pg 178 Original policy
S9500Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hoursColorado Prior Authorization List, Pg 178 Original policy
S9501Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hoursColorado Prior Authorization List, Pg 178 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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