This communication applies to the Commercial and Medicare Advantage programs from Anthem Blue Cross and Blue Shield (Anthem).

 

Effective for dates of service on and after February 1, 2023, the following code updates will apply to the AIM Specialty Health®* diagnostic coronary angiography and the percutaneous coronary intervention Clinical Appropriateness Guidelines.

 

Diagnostic coronary angiography:

CPT® code

Description

92973

Percutaneous transluminal coronary thrombectomy mechanical (list separately in addition to code for primary procedure)

92974

Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure)

92978

Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for primary procedure)

92979

Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to code for primary procedure)

 

Percutaneous coronary intervention:

CPT code

Description

92975

Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography

C1714

Catheter, transluminal atherectomy, directional

C1724

Catheter, transluminal atherectomy, rotational

C1725

Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)

C1753

Catheter, intravascular ultrasound

C1760

Closure device, vascular (implantable/insertable)

C1761

Catheter, transluminal intravascular lithotripsy, coronary

C1769

Guide wire

C1874

Stent, coated/covered, with delivery system

C1875

Stent, coated/covered, without delivery system

C1876

Stent, non-coated/non-covered, with delivery system

C1877

Stent, non-coated/non-covered, without delivery system

C1885

Catheter, transluminal angioplasty, laser

C1887

Catheter, guiding (may include infusion/perfusion capability)

 

As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:

  • Access AIM’s ProviderPortalSM directly at www.providerportal.com.
  • Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
  • Access AIM via Availity* Essentials at availity.com.

 

Detailed prior authorization requirements are available online at availity.com through the Precertification Lookup Tool.

 

If you have questions related to guidelines, contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Additionally, you may access and download a copy of the current and upcoming guidelines here.

*AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield.

*Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.
MULTI-BCBS-CRCM-008167-22-CPN7092



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December 2022 Provider Newsletter - New Hampshire