Updated Spine Care Referral Program questionnaire is now available

An updated questionnaire is now available on the Spine Care Referral Program Web pages on this website. The updated questionnaire includes the ICD-10 diagnosis codes that are comparable to the ICD-9 diagnosis codes previously included in the program. The ICD-10 codes are to be used for dates of service on or after Oct. 1, 2015.

The BCN Spine Care Referral Program is designed to ensure that all members with ongoing low back pain appropriately receive comprehensive and timely nonsurgical evaluation of their symptoms and condition prior to surgical evaluation.

As a reminder, non-emergent and non-urgent referrals for members 18 years of age or older submitted to a neurosurgeon or orthopedic surgeon for low back pain evaluation with these ICD-10 low back pain diagnoses require prior authorization. All members 18 or older with low back pain must be seen by a physical medicine and rehabilitation provider prior to referral to a neurosurgeon or orthopedic surgeon for the conditions represented by these diagnosis codes.