Policy Updates Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 16, 2024

Prior authorization requirement changes

Effective October 1, 2024

Effective October 1, 2024, the below CPT® codes will require prior authorization (PA). All covered services are contingent upon medical necessity and benefit coverage at the time of service.

The PA lookup tool allows providers to search codes by the specific line of business (Medicaid/SCHIP/Family Care, or Hoosier Care Connect) to determine if PA is required and which guideline is utilized for the case review. To access the PA lookup tool, go to providers.anthem.com/in, and select Precertification Lookup Tool under the Claims drop-down.

Contracted providers can also access the provider look up tool via Availity Essentials at Availity.com by selecting Payer Spaces and then selecting the Pre-cert Lookup tool tile.

For assistance with questions regarding the PA requirement change, please call Provider Services at one of the phone numbers listed below:

  • Hoosier Healthwise — 866-408-6132
  • Healthy Indiana Plan — 844-533-1995
  • Hoosier Care Connect — 844-284-1798
  • Indiana PathWays for Aging — 833-412-4405

CUMG number

CUMG title

CPT code

SG-CVS

N204

Cardiovascular Surgery or Procedure GRG

NCD Implantable Cardioverter Defibrillators (ICDs)

33263

SG-CVS

N204

Cardiovascular Surgery or Procedure GRG

NCD Implantable Cardioverter Defibrillators (ICDs)

33264

A-0973

SG-NS

L38528

Hypoglossal Nerve Stimulation, Implantable

Neurosurgery or Procedure GRG

LCD Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

64582

A-0270

Brachytherapy

C2616

N2028

SG-NS

SG-CVS

NCD Therapeutic Embolization

Neurosurgery or Procedure GRG

Cardiovascular Surgery or Procedure GRG

S2095

UM AROW A2024M141

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Providers who are contracted with Anthem Blue Cross and Blue Shield to serve Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for Aging through an accountable care organization (ACO), participating medical group (PMG) or Independent Physician Association (IPA) are to follow guidelines and practices of the group. This includes but is not limited to authorization, covered benefits and services, and claims submittal. If you have questions, please contact your group administrator or your Anthem network representative.

INBCBS-CD-058750-24-CPN58059

PUBLICATIONS: September 2024 Provider Newsletter