Guideline Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2023

Prior authorization requirement changes effective January 1, 2024

Precertification list change notification - October 2023

The following services will be added to precertification for the effective dates listed below.

Precertification responsibility: The ordering or rendering provider of service is responsible for completing the prior authorization process. 

HMO plans: Services that require precertification will be denied if rendered without the appropriate prior authorization for in-network providers. HMO members may not have benefits for non-emergency services rendered outside of the network and are subject to review and may be denied. 

PPO plans: Precertification for services requiring prior approval is highly recommended. If not completed in advance, a pre-payment review of the claim will occur and may result in a denial of claim reimbursement. 

EPO plans: Precertification for services requiring prior approval is highly recommended. If not completed in advance, a pre-payment review of the claim will occur and may result in a denial of claim reimbursement. No out of network benefit is available with the exception of emergency room (ER)/Urgent Care and authorized services.

To request precertification, access Availity Essentials* Availity.com. For maternity, medical, surgical precertification, call the number listed on the back of the member’s ID card.

For mental health and substance use disorder precertification, call 800-755-0851. Professionals are available 24 hours a day, seven days a week.

Add to precertification

Criteria

Criteria description

Code

Effective date

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0260U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0264U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0265U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0266U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0267U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0332U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0335U

1/1/2024

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0336U

1/1/2024

GENE.00057

Gene Expression Profiling for Idiopathic Pulmonary Fibrosis

81554

1/1/2024

LAB.00011

Selected Protein Biomarker Algorithmic Assays

0080U

1/1/2024

LAB.00011

Selected Protein Biomarker Algorithmic Assays

0247U

1/1/2024

LAB.00011

Selected Protein Biomarker Algorithmic Assays

0249U

1/1/2024

LAB.00011

Selected Protein Biomarker Algorithmic Assays

0360U

1/1/2024

LAB.00015

Detection of Circulating Tumor Cells

0337U

1/1/2024

LAB.00015

Detection of Circulating Tumor Cells

0338U

1/1/2024

LAB.00019

Proprietary Algorithms for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease

0002M

1/1/2024

LAB.00019

Proprietary Algorithms for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease

0003M

1/1/2024

LAB.00019

Proprietary Algorithms for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease

0344U

1/1/2024

LAB.00019

Proprietary Algorithms for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease

81596

1/1/2024

LAB.00024

Immune Cell Function Assay

86352

1/1/2024

LAB.00027

Selected Blood, Serum and Cellular Allergy and Toxicity Tests

86343

1/1/2024

LAB.00033

Protein Biomarkers for the Screening, Detection and Management of Prostate Cancer

0228U

1/1/2024

LAB.00033

Protein Biomarkers for the Screening, Detection and Management of Prostate Cancer

0359U

1/1/2024

LAB.00037

Serologic Testing for Biomarkers of Irritable Bowel Syndrome (IBS) 

0164U

1/1/2024

LAB.00037

Serologic Testing for Biomarkers of Irritable Bowel Syndrome (IBS) 

0176U

1/1/2024

LAB.00041

Machine Learning Derived Probability Score for Rapid Kidney Function Decline

0105U

1/1/2024

LAB.00046

Testing for Biochemical Markers for Alzheimer's Disease

0346U

1/1/2024

LAB.00046

Testing for Biochemical Markers for Alzheimer's Disease

0358U

1/1/2024

LAB.00046

Testing for Biochemical Markers for Alzheimer's Disease

0361U

1/1/2024

LAB.00048

Pain Management Biomarker Analysis

0117U

1/1/2024

MED.00004

Noninvasive Imaging Technologies for the Evaluation of Skin Lesions 

0658T

1/1/2024

MED.00004

Noninvasive Imaging Technologies for the Evaluation of Skin Lesions 

96904

1/1/2024

SURG.00092

Implanted Devices for Spinal Stenosis

0202T

1/1/2024

SURG.00092

Implanted Devices for Spinal Stenosis

C1821

1/1/2024

* Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc.

VABCBS-CM-037998-23

PUBLICATIONS: October 2023 Provider Newsletter