Anthem Blue Cross Blue Shield of Georgia policy
CG-ANC-04 Ambulance Services: Air and Water
CG-ANC-04 Ambulance Services: Air and Water is a public Anthem Blue Cross Blue Shield of Georgia policy (policy CG-ANC-04). It lists 8 CPT or HCPCS codes, 7 of them on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- CG-ANC-04
- 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 Georgia prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of Georgia policies |
|---|---|---|---|
| A0430 | On the list | Fixed Wing Air Transport | Policies naming A0430 |
| A0431 | On the list | Rotary Wing Air Transport | Policies naming A0431 |
| A0435 | On the list | Fixed Wing Air Mileage | Policies naming A0435 |
| A0436 | On the list | Rotary Wing Air Mileage | Policies naming A0436 |
| A0888 | On the list | Noncovered Ambulance Mileage | Policies naming A0888 |
| A0999 | Not listed | Policies naming A0999 | |
| S9960 | On the list | Ambulance service, conventional air services, nonemergency transport, one way (fixed wing) | Policies naming S9960 |
| S9961 | On the list | Ambulance service, conventional air service, nonemergency transport, one way (rotary wing) | Policies naming S9961 |
All Anthem Blue Cross Blue Shield of Georgia policies · Anthem Blue Cross Blue Shield of Georgia prior authorization CPT list