Sep 1, 2019 • State & Federal / Medicaid

Effective October 1, 2019, prior authorization (PA) requirements will change for hyperbaric oxygen and supervision of hyperbaric oxygen therapy to be covered by Anthem Blue Cross and Blue Shield. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services (CMS) guidelines, including definitions and specific contract provisions/exclusions, take precedence over these PA rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.

 

PA requirements will be added to the following:

  • G0277 – Hyperbaric oxygen under pressure, full body chamber, per 30-minute interval
  • 99183 – Physician attendance and supervision of hyperbaric oxygen therapy, per session

 

To request PA, you may use one of the following methods:

  • Web: availity.com
  • Fax:
    • o 1-866-406-2803 (inpatient – new emergent)
    • o 1-844-765-5156 (inpatient – concurrent emergent/new urgent)
    • o 1-844-765-5157 (outpatient)
  • Phone:
    • o Hoosier Healthwise: 1-866-408-6132
    • o Healthy Indiana Plan: 1-844-533-1995
    • o Hoosier Care Connect: 1-844-284-1798

 

Not all PA requirements are listed here. Detailed PA requirements are available to contracted providers by accessing the Precertification Lookup Tool at availity.com via anthem.com/inmedicaiddoc. Contracted and non-contracted providers who are unable to access the Availity Portal can call Provider Services for:

  • Hoosier Healthwise: 1‑866‑408‑6132
  • Healthy Indiana Plan: 1‑844‑533‑1995
  • Hoosier Care Connect: 1‑844‑284‑1798

 


Featured In:
September 2019 Anthem Provider News - Indiana