Prior authorization requirement changes effective December 1, 2022

On December 1, 2022, Anthem Blue Cross and Blue Shield prior authorization (PA) requirements will change for the following code. Federal and state law, as well as state contract language and CMS guidelines, including definitions and specific contract provisions/exclusions, take precedence over these precertification rules and must be considered first when determining coverage. Non-compliance with new requirements may result in denied claims.

 

Prior authorization requirements will be added for the following code:

 

L6715 — Terminal device, multiple articulating digit, includes motor(s), initial issue, or replacement

 

Not all PA requirements are listed here. Detailed PA requirements are available on the provider website or by accessing Availity*.

 

Providers may also call Provider Services for assistance with PA requirements by referencing the number on the back of the patient’s member ID card.

 

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

 

ABSCRNU-0329-22