Policy Updates Prior AuthorizationCommercialDecember 1, 2023

Empire BlueCross BlueShield precertification list change notification December 1, 2023

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

The following services will be added to precertification for the effective dates listed below. To obtain precertification, providers can access Availity at Availity.com or call Empire BlueCross BlueShield’s Utilization Management department using the number on the back of the member’s ID card. Service preapproval is based on member’s benefit plan/eligibility at the time the service is reviewed/approved.

Precertification can help avoid unnecessary charges or penalties by helping to ensure that the member’s care is medically necessary and administered at an appropriate network facility and by a network provider.

Add to precertification

Criteria

Criteria description

Code

Effective date

DME.00022

Functional Electrical Stimulation (FES); Threshold Electrical Stimulation (TES)

E0770

March 1, 2024

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

NYBCBS-CM-044967-23

PUBLICATIONS: December 2023 Provider Newsletter