CommercialPrior AuthHigh impact
[Georgia] Precertification list change notification
Anthem BCBS·GA · Gastroenterology, Cardiology, Oncology +1 more·Provider Bulletin
Effective date
Apr 15, 2026
We identified it
Aug 3, 2026
Summary
Anthem Blue Cross and Blue Shield in Georgia is adding seven new services to its precertification (prior authorization) requirements, effective on two dates: April 15, 2026 (two surgical procedures) and November 1, 2026 (five additional services including gene therapies, DME, and administrative requirements). Billing teams must obtain precertification before rendering these services or face claim reimbursement complications.
Action Required
By April 15, 2026: Billing and clinical staff must update precertification workflows to require prior authorization for CG-SURG-132 (Transendoscopic Therapy for Gastroesophageal Reflux Disease, Dysphagia, or Gastroparesis) and CG-SURG-133 (Intraluminal Left Atrial Appendage Closure Devices). By November 1, 2026: Extend precertification requirements to include ADMIN.00009 (Patient Safety), DME.00056 (Intrabuccal Amplitude-Modulated Radiofrequency Electromagnetic Field Device for Cancer Treatment), MED.00149 (Gene Therapy for Severe Leukocyte Adhesion Deficiency-I), MED.00165 (Gene Therapy for Treatment of Hearing Loss), and MED.00166 (Mucosal Integrity Testing). Update billing system rules, encounter forms, and provider alerts to flag these services for mandatory prior authorization submission before service delivery. Verify member eligibility through Availity Essentials (https://Availity.com) or member ID card phone number. Failure to obtain precertification prior to rendering designated services may result in claim denials and reimbursement complications.