CommercialSeptember 1, 2024
Precertification List Change Notification September 1, 2024
The following services will be added to precertification for the effective dates listed below.
To obtain precertification, providers can access Availity (Availity.com) or call 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 |
ANC.00008 | Cosmetic and Reconstructive Services of the Head and Neck | 21086 | 12/1/2024 |
ANC.00008 | Cosmetic and Reconstructive Services of the Head and Neck | L8045 | 12/1/2024 |
CG-DME-31 | Powered Wheeled Mobility Devices | E2298 | 12/1/2024 |
CG-SURG-118 | Intraocular Anterior Segment Aqueous Drainage Devices (without extraocular reservoir) | 0450T | 12/1/2024 |
LAB.00039 | Combined Pathogen Identification and Drug Resistance Testing | 0141U | 12/1/2024 |
LAB.00039 | Combined Pathogen Identification and Drug Resistance Testing | 0142U | 12/1/2024 |
LAB.00039 | Combined Pathogen Identification and Drug Resistance Testing | 0321U | 12/1/2024 |
LAB.00039 | Combined Pathogen Identification and Drug Resistance Testing | 0369U | 12/1/2024 |
LAB.00039 | Combined Pathogen Identification and Drug Resistance Testing | 0370U | 12/1/2024 |
LAB.00039 | Combined Pathogen Identification and Drug Resistance Testing | 0373U | 12/1/2024 |
LAB.00046 | Testing for Biochemical Markers for Alzheimer's Disease | 0445U | 12/1/2024 |
MED.00125 | Biofeedback and Neurofeedback | S9002 | 12/1/2024 |
OR-PR.00008 | Osseointegrated Limb Prostheses | L5991 | 12/1/2024 |
RAD.00059 | Catheter-based Embolization Procedures for Malignant Lesions Outside the Liver | C9797 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | A2026 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | C9796 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | Q4305 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | Q4306 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | Q4307 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | Q4308 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | Q4309 | 12/1/2024 |
SURG.00011 | Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting | Q4310 | 12/1/2024 |
SURG.00158 | Implantable Peripheral Nerve Stimulation Devices as a Treatment for Pain | A4438 | 12/1/2024 |
SURG.00162 | Implantable Shock Absorber for Treatment of Knee Osteoarthritis | C1734 | 12/1/2024 |
UM AROW #:A2024M1872
Commercial services provided by Anthem Blue Cross, trade name of Anthem HealthChoice HMO, Inc. and Anthem HealthChoice Assurance, Inc.
Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
NYBC-CM-064281-24-SRS63548
PUBLICATIONS: September 2024 Provider Newsletter
To view this article online:
Or scan this QR code with your phone