Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Anthem BCBSCommercial · Prior Auth · Provider Bulletin · VA · Cardiology, Urology, Vascular Surgery +5 moreMedium impact

[Virginia] Precertification/prior authorization list change notification

Act
by Nov 1, 2026
Effective date
Dec 1, 2026
Identified
Jul 10, 2026

Summary

Effective December 1, 2026, Anthem Blue Cross and Blue Shield in Virginia is adding 14 new services to its precertification/prior authorization requirement list. These include four advanced laboratory tests (Alzheimer's biomarkers, IBS serology, infectious disease sequencing, and prostate cancer protein biomarkers), two irreversible electroporation procedures, six carotid sinus baroreceptor stimulation device codes, and two gene therapy treatments. All services require prior authorization before delivery or claims may be denied.

Get alerts when payers change rules like this one

We check Anthem BCBS and other payers every day and email you when a change matches your specialty and state.

Get Anthem BCBS alertsPolicy Monitoring is free. No card required.

What to do

by Nov 1, 2026 · 6 steps
01Billing team must update the billing system to flag all 16 affected codes for mandatory prior authorization submission to Anthem before service delivery.
02Update encounter forms and provider templates to include these codes as requiring precertification.
03Communicate requirements to all clinical staff ordering these services—specifically laboratory personnel, cardiologists, vascular surgeons, urologists, and geneticists.
04Verify member eligibility and benefits through Availity Essentials before scheduling.
05Document that failure to obtain prior authorization will result in claim denials.
06Establish internal audit process to track compliance with the new requirement starting December 1, 2026.

Codes mentioned

47384558776465464655646566465764658646599314593146J3387J3389

Original notice

[Virginia] Precertification/prior authorization list change notification
providernews.anthem.com · Always check the source before changing claims.
View original ↗

Related changes

See all Anthem BCBS changes →
[Georgia] Precertification/prior authorization list change notificationHighEffective Nov 1, 2026 · Provider Bulletin[New York] Precertification/prior authorization list change notificationMediumEffective Dec 1, 2026 · Provider Bulletin[Ohio] Precertification/prior authorization list change notificationMediumEffective Dec 1, 2026 · Provider Bulletin[Ohio] Precertification/prior authorization requirement changesHighEffective Sep 1, 2026 · Provider BulletinBrowse every Anthem BCBS change in the policy list

Related policy hubs

Anthem BCBS policiesVA policy changesCardiologyUrologyVascular SurgeryGeneral SurgeryNeurologyGeneticsDermatologyPathologyCode 47384Code 55877Code 64654Code 64655Code 64656Code 64657Code 64658Code 64659Code 93145Code 93146Code J3387Code J3389

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account