Dec 1, 2020 • Administrative

We are committed to reducing cost while improving health outcomes. To that end, effective March 1, 2021, we will require prior authorization for our commercial business for the following services:

 

Code

Description

53447

Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session

53445

Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff

36465

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)

36466

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg

33477

Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed

 

Providers can submit pre-service review requests using one of the following ways:

  • Availity portal at www.availity.com. Online access is available 24/7 to process orders in real-time, and is the fastest and most convenient way to request authorization.
  • Call toll-free number at 800-392-1016, Monday – Friday, 8:30 a.m. to 5:00 p.m.

 

857-1220-PN-NE


Featured In:
December 2020 Anthem Maine Provider News