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[Georgia] Precertification/prior authorization requirement changes
Act
by Dec 31, 2026
Effective date
Jan 1, 2027
Identified
Aug 30, 2026
Summary
Effective January 1, 2027, Anthem Blue Cross and Blue Shield Medicare Advantage plans in Georgia will add prior authorization requirements for five specific codes: a prostate cancer biomarker test (0591U), genicular nerve destruction (64624), an electronic transanal irrigation system (A4479), prescription digital therapy (A9294), and a microprocessor-controlled ankle orthosis addition (L2221). Claims for these services will be denied if prior authorization is not obtained before service delivery.
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What to do
by Dec 31, 2026 · 5 steps
01Billing team must update billing system, EMR templates, and prior authorization workflows to require Anthem Medicare Advantage precertification for codes 0591U, 64624, A4479, A9294, and L2221 in Georgia.
02Providers must obtain prior authorization through Availity or by phone before delivering these services to Anthem Medicare Advantage members.
03Front desk staff should flag these codes during scheduling for Medicare Advantage patients.
04Failure to obtain prior authorization will result in claim denials and may require patient appeals.
05Update encounter forms to prompt providers to document medical necessity for these services.
Codes mentioned
64624A4479A9294L2221
Original notice
[Georgia] Precertification/prior authorization requirement changes
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[California] Precertification/prior authorization requirement changesMediumEffective Dec 1, 2026 · Provider Bulletin[California] Precertification/prior authorization requirement changesMediumEffective Jan 1, 2027 · Provider Bulletin[New York] Precertification/prior authorization requirement changesMediumEffective Jan 1, 2027 · Provider Bulletin[Ohio] Precertification/prior authorization requirement changesMediumEffective Jan 1, 2027 · Provider BulletinBrowse every Anthem BCBS change in the policy list