Anthem Blue Cross Blue Shield of Indiana policy

CG-ADMIN-01 Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline Exists

CG-ADMIN-01 Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline Exists is a public Anthem Blue Cross Blue Shield of Indiana policy (policy CG-ADMIN-01). It lists 62 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

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Payer
Anthem Blue Cross Blue Shield of Indiana
Policy number
CG-ADMIN-01
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.

CodeOther Anthem Blue Cross Blue Shield of Indiana policies
71045Policies naming 71045
71046Policies naming 71046
71047Policies naming 71047
72020Policies naming 72020
72040Policies naming 72040
72050Policies naming 72050
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73030Policies naming 73030
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73080Policies naming 73080
73090Policies naming 73090
73110Policies naming 73110
73130Policies naming 73130
73502Policies naming 73502
73503Policies naming 73503
73521Policies naming 73521
73522Policies naming 73522
73523Policies naming 73523
73560Policies naming 73560
73564Policies naming 73564
73590Policies naming 73590
73600Policies naming 73600
73610Policies naming 73610
73620Policies naming 73620
73630Policies naming 73630
73660Policies naming 73660
74021Policies naming 74021
76536Policies naming 76536
76700Policies naming 76700
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76770Policies naming 76770
76775Policies naming 76775
76881Policies naming 76881
76882Policies naming 76882
93886Policies naming 93886
93888Policies naming 93888
93892Policies naming 93892
93893Policies naming 93893
93896Policies naming 93896
93897Policies naming 93897
93898Policies naming 93898
93975Policies naming 93975
93976Policies naming 93976
96365Policies naming 96365
96366Policies naming 96366
96367Policies naming 96367
96368Policies naming 96368
96369Policies naming 96369
96370Policies naming 96370
96371Policies naming 96371
96372Policies naming 96372
96373Policies naming 96373
96374Policies naming 96374
96375Policies naming 96375
96376Policies naming 96376
96377Policies naming 96377
96379Policies naming 96379

All Anthem Blue Cross Blue Shield of Indiana policies

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.