Reminder: eviCore healthcare to review additional outpatient pain management services for BCN effective Dec. 1

As a reminder, for dates of service on or after Dec. 1, 2016, authorization is required through eviCore healthcare for additional pediatric and adult outpatient interventional pain management services for Blue Care Network HMO^SM (commercial) and BCN Advantage^SM members, for all diagnoses. Currently, eviCore reviews epidural and facet joint injections for BCN.

You can submit authorization requests for these additional procedures as early as Nov. 21 at www.evicore.com. Click Providers and log in to eviCore's provider portal.

The codes for the additional services that eviCore will review are: *0213T, *0214T, *0215T, *0216T, *0217T, *0218T, *0228T, *0229T, *0230T, *0231T, *27096, *62263, *62264, *62280, *64470, *64472, *64475, *64476, *64510, *64520, *64620, *64626, *64627, *64633, *64634, *64635 and *64636. These services include sacroiliac joint injections, epidural adhesiolysis, radio frequency ablation and regional sympathetic blocks.

The list of procedures that require review by eviCore healthcare has been updated to reflect these additional codes.

Authorization from eviCore is required for these outpatient pain management services. Services performed without authorization may be denied for payment.

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

Posted: November 2016
Line of business: Blue Care Network