CommercialPrior AuthMedium impact
[Virginia] VA precertification/prior authorization list change notification
Anthem BCBS·VA · Dermatology, Neurosurgery, Radiology·Provider Bulletin
Effective date
Dec 1, 2026
We identified it
Jul 28, 2026
Summary
Effective December 1, 2026, Anthem Blue Cross and Blue Shield in Virginia is adding three services to its precertification/prior authorization requirement list: noninvasive imaging for skin lesion evaluation (CPT 1020T), and two percutaneous spinal surgery procedures (CPT 62330 and 62331). Providers must obtain prior authorization before rendering these services or risk claim denial.
Action Required
Before December 1, 2026: Billing team must update prior authorization workflow in billing software to require precertification for CPT 1020T (noninvasive imaging for skin lesions), CPT 62330 (percutaneous spinal surgery), and CPT 62331 (percutaneous spinal surgery). Update provider encounter templates and internal compliance checklists to reflect new prior auth requirements for Anthem/HealthKeepers commercial plans in Virginia. Configure system to flag these codes for prior authorization submission through Availity Essentials or phone contact (800-755-0851 for mental health/substance abuse; member ID card number for maternity/medical/surgical). Communicate changes to ordering and rendering providers. Claims submitted without prior authorization for these codes will be deemed ineligible for payment effective December 1, 2026.