CommercialPrior AuthMedium impact
[Georgia] Precertification/prior authorization list change notification
Anthem BCBS·GA · Dermatology, Neurosurgery, Orthopedics +1 more·Provider Bulletin
Effective date
Dec 1, 2026
We identified it
Jul 16, 2026
Summary
Effective December 1, 2026, Anthem Blue Cross and Blue Shield in Georgia is adding three services to its precertification/prior authorization requirements: noninvasive imaging for skin lesion evaluation (CPT 1020T) and percutaneous spinal surgery procedures (CPT 62330 and 62331). Providers must obtain prior authorization before delivering these services or risk claim denials.
Action Required
Before December 1, 2026: Billing team must update the billing system and prior authorization workflows to require precertification for CPT codes 1020T, 62330, and 62331 for all Anthem Georgia commercial members. Clinical staff and providers should be notified of the new requirements. Establish processes to submit prior authorization requests through Availity Essentials or Provider Services before scheduling or performing these procedures. Ensure eligibility verification occurs at time of service review, as benefit plans vary by contract. Claims submitted without required prior authorization will be denied for payment.