This page provides information about:

• Joint procedures
• Pain management procedures
• Spine procedures
• Resources, forms and training for TurningPoint

For information about musculoskeletal services for BCN HMO^SM and BCN Advantage^SM members, see the BCN Musculoskeletal Services page.

For information about musculoskeletal services for Blue Cross’ PPO and Medicare Plus Blue^SM PPO members, see the Blue Cross Musculoskeletal Services page.

Joint procedures

Joint procedures

Providers must obtain authorizations for joint replacement surgeries and other related arthroscopic procedures as follows, based on the member's plan or group and the date of service:

Plan or group	Date of service	Details
Medicare Plus BlueSM PPO	Prior to July 1, 2020	Submit authorization requests to Medicare Plus Blue Utilization Management through the e-referral system. For more information, see the "For Medicare Plus Blue PPO members" section of the Blue Cross Authorization Requirements & Criteria page.
	On or after July 1, 2020	Submit authorization requests to TurningPoint Healthcare Solutions LLC.
All Blue Cross' PPO fully insured groups Select Blue Cross' PPO administrative service contract groups	Prior to Jan. 1, 2021	Authorization isn't required.
	On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.
BCN HMOSM BCN AdvantageSM	Prior to July 1, 2020	Submit authorization requests to Blue Care Network Utilization Management through the e-referral system. For more information, see the BCN Authorization Requirements & Criteria page.
	On or after July 1, 2020	Submit authorization requests to TurningPoint Healthcare Solutions LLC.

See also: Resources, forms and training for TurningPoint.

Pain management procedures

Pain management procedures

Providers must obtain authorizations for pain management procedures as follows, based on the member’s plan or group and the date of service:

Plan or group	Date of service	Details
All Blue Cross' PPO fully insured groups Select Blue Cross' PPO administrative service contract groups Medicare Plus Blue	Prior to Jan. 1, 2021	Submit authorization requests to eviCore healthcare®. For more information, see the Blue Cross eviCore-Managed Procedures page.
	On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.
BCN HMO BCN Advantage	Prior to Jan. 1, 2021	Submit authorization requests to eviCore healthcare®. For more information, see the BCN eviCore-Managed Procedures page.
	On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.

See also: Resources, forms and training for TurningPoint

Spine procedures

Spine procedures

Providers must obtain authorizations for spinal surgeries as follows, based on the type of surgery or procedure, the member’s plan or group and the date of service:

Providers must obtain authorizations for spinal surgeries as follows, based on the member’s plan or group and the date of service:

Surgery or procedure	Plan or group	Date of service	Details
Cervical spine	Blue Cross' PPO fully insured groups Select Blue Cross' PPO ASC groups Medicare Plus Blue	Prior to Jan. 1, 2021	Authorization isn't required.
		On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.
Lumbar spine	Blue Cross' PPO fully insured groups Medicare Plus Blue	Prior to Jan. 1, 2021	Submit authorization requests to eviCore healthcare. For more information, see the Blue Cross eviCore-Managed Procedures page.
		On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.
	Select Blue Cross' PPO ASC groups	Prior to Jan. 1, 2021	Authorization isn't required.
		On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.
Catheter implantations on spine and spinal cord Reservoir pump/pump implantation procedure on spine and spinal cord Neurostimulator (spine) procedures	Blue Cross' PPO fully insured groups Select Blue Cross' PPO ASC groups	Prior to Jan. 1, 2021	Authorization isn't required.
		On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.
	Medicare Plus Blue	Prior to Jan. 1, 2021	Submit authorization requests to Medicare Plus Blue Utilization Management.
		On or after Jan. 1, 2021	Starting Dec. 1, 2020, submit authorization requests to TurningPoint.

Plan or group	Date of service	Details
BCN HMO BCN Advantage	Prior to July 1, 2020	Submit authorization requests to BCN Utilization Management through the e-referral system. For more information, see the BCN Authorization Requirements & Criteria page.
	On or after July 1, 2020	Submit authorization requests to TurningPoint.

See also: Resources, forms and training for TurningPoint

Resources, forms and training for TurningPoint

Resources, forms and training for TurningPoint

Refer to the following resources for more information:

• Musculoskeletal procedure codes that require authorization by TurningPoint (PDF)
• Clinical documentation requirements for musculoskeletal procedures (PDF)
• Musculoskeletal procedure authorizations: Frequently asked questions for providers (PDF)
• Musculoskeletal procedure authorizations: Quick reference for providers (PDF)
• TurningPoint Provider Training Manual (PDF)

TurningPoint forms

• Joint and spine procedures authorization request form (PDF)
• Pain management: Epidural steroid injections authorization request form (PDF)
• Pain management: Facet joint injections authorization request form (PDF)
• Pain management: Neuroablation procedures authorization request form (PDF)
• Pain management: Sacroiliac joint injections authorization request form (PDF)
• Postservice change request form (PDF)

To determine which pain management form to submit, see the “Pain management” section of the Musculoskeletal procedure codes that require authorization by TurningPoint document (PDF). This document specifies which procedure codes fall within each pain management category.

Turning Point provider training – Spine and joint, for the July 1, 2020 program implementation

• Professional provider training — Includes information about TurningPoint's clinical model and operational changes, along with information about working in the TurningPoint Provider Portal
• Webinar recording* — Available on TurningPoint’s Blue Cross & BCN Webinars webpage
• Presentation (slides only) (PDF)
• Facility training — Includes information about TurningPoint's clinical model and operational changes, along with information about the facility verification process
• Webinar recording* — Available on TurningPoint's Blue Cross & BCN Webinars webpage
• Presentation (slides only) (PDF)
• Portal training — Includes information about working in the TurningPoint Provider Portal
• Webinar recording* — Available on TurningPoint’s Blue Cross & BCN Webinars webpage
• Presentation (slides only) (PDF)

See the BCN Musculoskeletal Services page for information specific to BCN HMO and BCN Advantage members.

See the Blue Cross Musculoskeletal Services page for information specific to Blue Cross' PPO and Medicare Plug Blue members.

*Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're required to let you know we're not responsible for its content.