Anthem Blue Cross: Prior Authorization Requirements: New 2020 Codes for Coverage and Precertification

Effective June 1, 2020, prior authorization (PA) requirements will change for the following services to be covered for Anthem Blue Cross members. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services guidelines, including definitions and specific contract provisions/exclusions, take precedence over these PA rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.

PA requirements will be added to the following codes:0153U, 0154U,0155U, 0156U , 0157U, 0158U ,0159U, 0160U ,0161U ,0162U ,0571T ,0572T ,0581T ,0584T, 0585T , 0586T, 64451 ,64454 ,64624 ,78429 ,78430 , 78431 , 81277 , 81307 ,81308 , 81309 ,81522 , C9757 , E2398, J0179 ,J9309 ,K1001

Source: https://www11.anthem.com/ca/shared/f2/s2/t1/pw_g395176.pdf