CommercialDecember 1, 2023
Precertification list change notification
The following services will be added to precertification for the effective dates listed below.
Eligibility and benefits can be verified by accessing Availity.com or by calling the number on the back of the member’s identification card. Service precertification is based on member’s benefit plan/eligibility at the time the service is reviewed/approved. Benefit plans vary widely and are subject to change based on the contract effective dates. The provider is responsible for verification of member eligibility and covered benefits.
Except in the case of an emergency, failure to obtain precertification prior to rendering the designated services listed below may result in denial of reimbursement.
Criteria added to precertification
Criteria | Criteria description | Effective date |
MED.00011 | Sensory Stimulation for Brain-Injured Individuals in Coma or Vegetative State | 3/1/2024 |
MED.00024 | Adoptive Immunotherapy and Cellular Therapy | 3/1/2024 |
MED.00082 | Quantitative Sensory Testing | 3/1/2024 |
MED.00092 | Automated Nerve Conduction Testing | 3/1/2024 |
MED.00096 | Low-Frequency Ultrasound Therapy for Wound Management | 3/1/2024 |
MED.00098 | Hyperoxemic Reperfusion Therapy | 3/1/2024 |
MED.00103 | Automated Evacuation of Meibomian Gland | 3/1/2024 |
MED.00105 | Bioimpedance Spectroscopy Devices for the Detection and Management of Lymphedema | 3/1/2024 |
MED.00111 | Intracardiac Ischemia Monitoring | 3/1/2024 |
MED.00131 | Electronic Home Visual Field Monitoring | 3/1/2024 |
MED.00134 | Non-invasive Heart Failure and Arrhythmia Management and Monitoring System | 3/1/2024 |
MED.00137 | Eye Movement Analysis Using Non-spatial Calibration for the Diagnosis of Concussion | 3/1/2024 |
MED.00141 | High-volume Colonic Irrigation | 3/1/2024 |
RAD.00053 | Cervical and Thoracic Discography | 3/1/2024 |
Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
GABCBS-CM-044086-23
PUBLICATIONS: December 2023 Provider Newsletter
To view this article online:
Or scan this QR code with your phone