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Request Prior Plan Approval. Blue Cross NC makes your job easier. Get the right CPT codes for medical services & procedures, claims processing and prior review all in one place.
Using our new digital lookup tool, you can conduct a search by entering a 5-digit procedure code, service description or drug name. The tool returns information for procedures that may require prior authorization through BCBSIL or AIM Specialty Health ® (AIM) for commercial fully insured non-HMO members.
Procedure Code Look Up. Locate procedure codes that may require prior authorization for Fully Insured Members Only using the following: Digital Lookup Tool. Select the appropriate category below to find out if a member’s procedure may require prior authorization: Medical Procedure. Medical Drugs.
Our Prior Authorization Procedure Search tool allows you to enter a CPT® or HCPCS code and select a place of service (e.g., inpatient, outpatient, office, home) to determine if the particular service provided in the selected service setting requires a prior authorization.
Please note: This tool can be used to check if a prior authorization is required for health care services covered by Blue Cross and Blue Shield of Minnesota commercial health plans, Medicare Advantage and Platinum Blue.
How to check benefit preauthorization requirements online for CPT/HCPCS codes: Enter the optional CPT/HCPCS code (s) and the associated place of service on the Eligibility and Benefit Inquiry entry screen (270), through the Availity portal or your preferred web vendor.
To determine coverage of a particular service or procedure for a specific member: Access eligibility and benefits information on the Availity Web Portal or. Use the Prior Authorization Lookup Tool within Availity or. Contact the Customer Care Center:
Click Search or an arrow to search for the procedure code. Procedure codes are listed more than once in the following situations: • They’re managed by a different entity (Blue Cross Blue Shield of Michigan, Blue Care Network or a contracted vendor) for different lines of
To determine coverage of a particular service or procedure for a specific member: Access eligibility and benefits information on the Availity Web Portal * or. Use the Prior Authorization tool within Availity or. Call Provider Services at 1-800-450-8753 (TTY 711)
2022 Benefit Procedure Code List Updated January 2022 EXCEPT AS OTHERWISE NOTED IN THE DATE COLUMN, THESE CODES ARE EFFECTIVE ON OR BEFORE JANUARY 1, 2022. Our medical policy impacts all our coverage decisions.