Anthem Blue Cross and Blue Shield | CommercialDecember 30, 2022
Notice of material change/amendment to contract
Anthem Blue Cross and Blue Shield local precertification change in Maine
The following services will be added to precertification for the effective dates listed below.
To obtain precertification, providers can access Availity Essentials* at www.availity.com or call the 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.
Criteria | Criteria description | Codes | Effective date |
LAB.00011 | Selected Protein Biomarker Algorithmic Assays | 0080U | April 1, 2023 |
LAB.00011 | Selected Protein Biomarker Algorithmic Assays | 0092U | April 1, 2023 |
LAB.00011 | Selected Protein Biomarker Algorithmic Assays | 0174U | April 1, 2023 |
LAB.00011 | Selected Protein Biomarker Algorithmic Assays | 0247U | April 1, 2023 |
LAB.00011 | Selected Protein Biomarker Algorithmic Assays | 0249U | April 1, 2023 |
LAB.00015 | Detection of Circulating Tumor Cells | 0317U | April 1, 2023 |
SURG.00121 | Transcatheter Heart Valve Procedures | 0483T | April 1, 2023 |
SURG.00121 | Transcatheter Heart Valve Procedures | 0484T | April 1, 2023 |
SURG.00104 | Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis | 0510T | April 1, 2023 |
SURG.00104 | Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis | 0511T | April 1, 2023 |
SURG.00121 | Transcatheter Heart Valve Procedures | 0544T | April 1, 2023 |
SURG.00121 | Transcatheter Heart Valve Procedures | 0545T | April 1, 2023 |
LAB.00003 | In Vitro Chemosensitivity Assays and In Vitro Chemoresistance Assays | 0564T | April 1, 2023 |
SURG.00121 | Transcatheter Heart Valve Procedures | 0646T | April 1, 2023 |
CG-SURG-95 | Sacral Nerve Stimulation and Percutaneous Tibial Nerve Stimulation for Urinary and Fecal Incontinence; Urinary Retention | 64585 | April 1, 2023 |
CG-MED-79 | Diaphragmatic/Phrenic Nerve Stimulation and Diaphragm Pacing Systems | C1823 | April 1, 2023 |
SURG.00124 | Carotid Sinus Baroreceptor Stimulation Devices | C1825 | April 1, 2023 |
* Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.
MEBCBS-CM-012053-22
PUBLICATIONS: January 2023 Provider Newsletter - Maine
To view this article online:
Or scan this QR code with your phone