Policy Updates Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingApril 21, 2025

New preapproval requirements for coronary artery catheter placement procedures

Indiana | Anthem Blue Cross and Blue Shield | Serving Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging

Effective August 1, 2025, the CPT® codes listed below require preapproval.

Clinical Utilization Management Guideline (CUMG) number

CUMG title

CPT code

MCG A‑0001

Cardiac Catheterization and Angiography

C7552 and C7553

To view a complete list of preapproval requirements:

  • You can access detailed preapproval requirements via the provider self‑service tool at https://Availity.com.
  • If you do not have access to Availity, we offer a Precertification Lookup Tool, which allows you to search codes by line of business and program. To access the Precertification Lookup Tool, visit https://providers.anthem.com/in and select Precertification Lookup Tool under the Claims drop‑down.

To request preapproval:

  • From the Availity homepage, select Patient Registration from the top navigation.
  • Then, select Auth/Referral Inquiry or Authorizations.

Please note that all covered services are contingent upon medical necessity and benefit coverage at the time of service. To determine coverage of a particular service or procedure for a specific member, you can access eligibility and benefits information within Availity Essentials. If you do not have access to Availity Essentials, please contact Provider Services at 866‑408‑6132 (Hoosier Healthwise), 844‑533‑1995 (Healthy Indiana Plan), 844‑284‑1798 (Hoosier Care Connect), or 833‑569‑4739 (Indiana PathWays for Aging).

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Providers who are contracted with Anthem Blue Cross and Blue Shield to serve Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for Aging through an accountable care organization (ACO), participating medical group (PMG) or Independent Physician Association (IPA) are to follow guidelines and practices of the group. This includes but is not limited to authorization, covered benefits and services, and claims submittal. If you have questions, please contact your group administrator or your Anthem network representative.

INBCBS-CD-076333-25

PUBLICATIONS: May 2025 Provider Newsletter