Preapproval list change notification (MAC)

Material adverse change

 

The following services will be added to prior authorization for GA local members for the effective dates listed below.

 

Eligibility and benefits can be verified by accessing Availity* via the Anthem Blue Cross and Blue Shield (Anthem) provider website or by calling the number on the back of the member’s identification card. Service preapproval is based on the member’s benefit plan/eligibility at the time the service is reviewed/approved. Benefit plans vary widely and are subject to change based on the contract effective dates. The provider is responsible for verification of member eligibility and covered benefits.

 

Except in the case of an emergency, failure to obtain approval prior to rendering the designated services listed below may result in denial of reimbursement.

 

 

Criteria	Criteria Description	Code	Effective Date
SURG.00150	Leadless Pacemaker	33274	Add 03/01/2023
SURG.00150	Leadless Pacemaker	33275	Add 03/01/2023

 

 

* Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.

GABCBS-CM-009974-22