Wellpoint policy

West Virginia Provider Manual

West Virginia Provider Manual is a public Wellpoint policy (policy WVWP-CD-055335-24, effective Apr 1, 2022). It lists 316 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Wellpoint
Policy number
WVWP-CD-055335-24
Effective
Apr 1, 2022
Line of business
Medicaid
States
WV
Source
www.wellpoint.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Wellpoint policies
25301Policies naming 25301
44181Policies naming 44181
53051Policies naming 53051
53201Policies naming 53201
81139Policies naming 81139
D0120Policies naming D0120
D0140Policies naming D0140
D0145Policies naming D0145
D0150Policies naming D0150
D0180Policies naming D0180
D0210Policies naming D0210
D0220Policies naming D0220
D0230Policies naming D0230
D0240Policies naming D0240
D0250Policies naming D0250
D0270Policies naming D0270
D0272Policies naming D0272
D0273Policies naming D0273
D0274Policies naming D0274
D0310Policies naming D0310
D0320Policies naming D0320
D0321Policies naming D0321
D0322Policies naming D0322
D0330Policies naming D0330
D0340Policies naming D0340
D0350Policies naming D0350
D0470Policies naming D0470
D0474Policies naming D0474
D0486Policies naming D0486
D0520Policies naming D0520
D0999Policies naming D0999
D1020Policies naming D1020
D1040Policies naming D1040
D1045Policies naming D1045
D1110Policies naming D1110
D1120Policies naming D1120
D1206Policies naming D1206
D1208Policies naming D1208
D1320Policies naming D1320
D1351Policies naming D1351
D1353Policies naming D1353
D1354Policies naming D1354
D1510Policies naming D1510
D1516Policies naming D1516
D1517Policies naming D1517
D1520Policies naming D1520
D1526Policies naming D1526
D1527Policies naming D1527
D1551Policies naming D1551
D1552Policies naming D1552
D1553Policies naming D1553
D1575Policies naming D1575
D2140Policies naming D2140
D2150Policies naming D2150
D2160Policies naming D2160
D2161Policies naming D2161
D2330Policies naming D2330
D2331Policies naming D2331
D2332Policies naming D2332
D2335Policies naming D2335
D2390Policies naming D2390
D2391Policies naming D2391
D2392Policies naming D2392
D2393Policies naming D2393
D2394Policies naming D2394
D2740Policies naming D2740
D2750Policies naming D2750
D2751Policies naming D2751
D2752Policies naming D2752
D2791Policies naming D2791
D2792Policies naming D2792
D2920Policies naming D2920
D2928Policies naming D2928
D2930Policies naming D2930
D2931Policies naming D2931
D2932Policies naming D2932
D2933Policies naming D2933
D2940Policies naming D2940
D2950Policies naming D2950
D2951Policies naming D2951
D2952Policies naming D2952
D2954Policies naming D2954
D3220Policies naming D3220
D3310Policies naming D3310
D3320Policies naming D3320
D3330Policies naming D3330
D3346Policies naming D3346
D3347Policies naming D3347
D3348Policies naming D3348
D3351Policies naming D3351
D3352Policies naming D3352
D3353Policies naming D3353
D3410Policies naming D3410
D3421Policies naming D3421
D3999Policies naming D3999
D4210Policies naming D4210
D4211Policies naming D4211
D4260Policies naming D4260
D4261Policies naming D4261
D4341Policies naming D4341
D4342Policies naming D4342
D4346Policies naming D4346
D4355Policies naming D4355
D4910Policies naming D4910
D4999Policies naming D4999
D5110Policies naming D5110
D5120Policies naming D5120
D5130Policies naming D5130
D5140Policies naming D5140
D5211Policies naming D5211
D5212Policies naming D5212
D5213Policies naming D5213
D5214Policies naming D5214
D5225Policies naming D5225
D5226Policies naming D5226
D5281Policies naming D5281
D5282Policies naming D5282
D5283Policies naming D5283
D5284Policies naming D5284
D5286Policies naming D5286
D5410Policies naming D5410
D5411Policies naming D5411
D5421Policies naming D5421
D5422Policies naming D5422
D5511Policies naming D5511
D5512Policies naming D5512
D5520Policies naming D5520
D5611Policies naming D5611
D5612Policies naming D5612
D5621Policies naming D5621
D5622Policies naming D5622
D5630Policies naming D5630
D5640Policies naming D5640
D5650Policies naming D5650
D5660Policies naming D5660
D5710Policies naming D5710
D5711Policies naming D5711
D5720Policies naming D5720
D5721Policies naming D5721
D5730Policies naming D5730
D5731Policies naming D5731
D5740Policies naming D5740
D5741Policies naming D5741
D5750Policies naming D5750
D5751Policies naming D5751
D5760Policies naming D5760
D5761Policies naming D5761
D5810Policies naming D5810
D5811Policies naming D5811
D5820Policies naming D5820
D5821Policies naming D5821
D5850Policies naming D5850
D5851Policies naming D5851
D5899Policies naming D5899
D5911Policies naming D5911
D5912Policies naming D5912
D5913Policies naming D5913
D5914Policies naming D5914
D5915Policies naming D5915
D5916Policies naming D5916
D5919Policies naming D5919
D5924Policies naming D5924
D5925Policies naming D5925
D5931Policies naming D5931
D5932Policies naming D5932
D5933Policies naming D5933
D5934Policies naming D5934
D5935Policies naming D5935
D5937Policies naming D5937
D5951Policies naming D5951
D5952Policies naming D5952
D5954Policies naming D5954
D5955Policies naming D5955
D5982Policies naming D5982
D5983Policies naming D5983
D5984Policies naming D5984
D5985Policies naming D5985
D5986Policies naming D5986
D5987Policies naming D5987
D5999Policies naming D5999
D6211Policies naming D6211
D6241Policies naming D6241
D6545Policies naming D6545
D6930Policies naming D6930
D6999Policies naming D6999
D7140Policies naming D7140
D7210Policies naming D7210
D7220Policies naming D7220
D7230Policies naming D7230
D7240Policies naming D7240
D7250Policies naming D7250
D7260Policies naming D7260
D7270Policies naming D7270
D7280Policies naming D7280
D7283Policies naming D7283
D7285Policies naming D7285
D7286Policies naming D7286
D7310Policies naming D7310
D7320Policies naming D7320
D7340Policies naming D7340
D7350Policies naming D7350
D7410Policies naming D7410
D7411Policies naming D7411
D7440Policies naming D7440
D7441Policies naming D7441
D7450Policies naming D7450
D7451Policies naming D7451
D7460Policies naming D7460
D7461Policies naming D7461
D7471Policies naming D7471
D7472Policies naming D7472
D7473Policies naming D7473
D7485Policies naming D7485
D7490Policies naming D7490
D7510Policies naming D7510
D7520Policies naming D7520
D7530Policies naming D7530
D7550Policies naming D7550
D7560Policies naming D7560
D7610Policies naming D7610
D7620Policies naming D7620
D7630Policies naming D7630
D7640Policies naming D7640
D7671Policies naming D7671
D7680Policies naming D7680
D7710Policies naming D7710
D7720Policies naming D7720
D7730Policies naming D7730
D7740Policies naming D7740
D7750Policies naming D7750
D7770Policies naming D7770
D7780Policies naming D7780
D7810Policies naming D7810
D7820Policies naming D7820
D7830Policies naming D7830
D7850Policies naming D7850
D7852Policies naming D7852
D7858Policies naming D7858
D7865Policies naming D7865
D7870Policies naming D7870
D7872Policies naming D7872
D7873Policies naming D7873
D7874Policies naming D7874
D7876Policies naming D7876
D7877Policies naming D7877
D7880Policies naming D7880
D7910Policies naming D7910
D7911Policies naming D7911
D7912Policies naming D7912
D7920Policies naming D7920
D7922Policies naming D7922
D7941Policies naming D7941
D7943Policies naming D7943
D7944Policies naming D7944
D7946Policies naming D7946
D7947Policies naming D7947
D7948Policies naming D7948
D7949Policies naming D7949
D7950Policies naming D7950
D7955Policies naming D7955
D7960Policies naming D7960
D7961Policies naming D7961
D7962Policies naming D7962
D7970Policies naming D7970
D7979Policies naming D7979
D7980Policies naming D7980
D7981Policies naming D7981
D7982Policies naming D7982
D7991Policies naming D7991
D7999Policies naming D7999
D8010Policies naming D8010
D8020Policies naming D8020
D8030Policies naming D8030
D8040Policies naming D8040
D8050Policies naming D8050
D8060Policies naming D8060
D8070Policies naming D8070
D8080Policies naming D8080
D8090Policies naming D8090
D8210Policies naming D8210
D8220Policies naming D8220
D8680Policies naming D8680
D8690Policies naming D8690
D8693Policies naming D8693
D8695Policies naming D8695
D8696Policies naming D8696
D8697Policies naming D8697
D8698Policies naming D8698
D8699Policies naming D8699
D8701Policies naming D8701
D8702Policies naming D8702
D8703Policies naming D8703
D8704Policies naming D8704
D8999Policies naming D8999
D9222Policies naming D9222
D9223Policies naming D9223
D9230Policies naming D9230
D9239Policies naming D9239
D9243Policies naming D9243
D9310Policies naming D9310

And 16 more in the original policy.

All Wellpoint 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.