Policy Updates Prior AuthorizationCommercialNovember 1, 2024

Precertification List Change Notification — November 1, 2024

The following services will be added to precertification for the effective dates listed below.

Eligibility and benefits can be verified by accessing Availity at Availity.com or calling Anthem’s 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.

Add to precertification

Criteria

Criteria description

Code

Effective date

MED.00140

Gene Therapy for Beta Thalassemia

J3393

2/1/2025

MED.00146

Gene Therapy for Sickle Cell Disease

J3394

2/1/2025

Commercial services provided by Anthem Blue Cross and Blue Shield, trade name of Anthem HealthChoice HMO, Inc. and Anthem HealthChoice Assurance, Inc., or Anthem Blue Cross and Blue Shield HP, trade name of Anthem HP, LLC.
Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CM-068529-24

PUBLICATIONS: November 2024 Provider Newsletter