eviCore to review additional radiation therapy codes for BCN effective Nov. 1, 2016

Effective for dates of service on or after Nov. 1, 2016, eviCore healthcare will review authorization requests for additional radiation therapy services, for BCN HMO^SM (commercial) and BCN Advantage^SM members.

These additional services are associated with the following procedure codes: *79101, *79403, A9543, C2616 and Q3001

Here's what you need to know:

• Authorization is required prior to services being given.
• You'll need to submit pertinent clinical information with the authorization request

An updated list of codes reviewed by eviCore, including these additional codes, is available on the eviCore Managed Procedures page on this website.

As a reminder, BCN contracts with eviCore healthcare to review select non-emergent cardiology, interventional pain management, radiation therapy and radiologyprocedures when performed in freestanding diagnostic facilities, outpatient hospital settings, ambulatory surgery centers and physician offices for BCN HMO and BCN Advantage members.

* CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.

Posted: September 2016
Line of business: Blue Care Network