Policy Updates Prior AuthorizationCommercialFebruary 1, 2024

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

Criteria description

Code

Effective date

CG-DME-07,
CG-DME-34

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output
Wheeled Mobility Devices: Wheelchair Accessories

E2351

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2500

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2502

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2504

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2506

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2508

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2510

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2511

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2512

May 1, 2024

CG-DME-07

Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

E2599

May 1, 2024

CG-DME-33

Wheeled Mobility Devices: Manual Wheelchairs–Ultra Lightweight

K0005

May 1, 2024

Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

NVBCBS-CM-048208-23

PUBLICATIONS: February 2024 Provider Newsletter