CommercialMarch 12, 2024
Anthem Precertification List Change Notification for September 2023
This article was previously posted with archived criteria CG-SURG-27 which has been removed. Previous article here.
The following services will be added to precertification for the effective dates listed below.
To obtain precertification, providers can access Availity Essentials (Availity.com) or call Anthem’s Utilization Management department using the number on the back of the member’s identification card. Service preapproval is based on member’s benefit plan/eligibility at the time the service is reviewed/approved.
Precertification can help avoid unnecessary charges or penalties by helping to ensure that the member's care is medically necessary and administered at an appropriate network facility and by a network provider.
Add to precertification | |||
Criteria | Criteria description | Code | Effective date |
CG-SURG-09 | Temporomandibular Disorders | D7899 | 12/01/2023 |
CG-SURG-09 | Temporomandibular Disorders | D9950 | 12/01/2023 |
CG-SURG-09 | Temporomandibular Disorders | D9951 | 12/01/2023 |
CG-SURG-09 | Temporomandibular Disorders | D9952 | 12/01/2023 |
CG-DME-06 | Compression Devices for Lymphedema | E0656 | 12/01/2023 |
CG-DME-06 | Compression Devices for Lymphedema | E0657 | 12/01/2023 |
CG-DME-45 | Ultrasound Bone Growth Stimulation | E0760 | 12/01/2023 |
CG-DME-06 | Compression Devices for Lymphedema | K1024 | 12/01/2023 |
CG-DME-06 | Compression Devices for Lymphedema | K1025 | 12/01/2023 |
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
CTBCBS-CM-049080-24-SRS49080
PUBLICATIONS: April 2024 Provider Newsletter
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