Starting June 27, updated questionnaires to open in the e-referral system
On June 27, 2021, we'll update the following questionnaires in the e-referral system:
- Artificial heart, total - For adult and pediatric Blue Care Network commercial members. This questionnaire will no longer open for procedure code *33929. It will begin opening for procedure code *33995 and will continue to open for the other codes listed in the Artificial heart, total (PDF) preview questionnaire.
- Hammertoe correction surgery - For adult Medicare Plus BlueSM, BCN commercial and BCN AdvantageSM members. This questionnaire will no longer open for procedure code *28160. It will continue to open for the other procedures codes listed in the Hammertoe correction surgery (PDF) preview questionnaire.
- Pediatric feeding - For BCN commercial members ages 18 and younger
We'll also update the corresponding preview questionnaire on the ereferrals.bcbsm.com website.
As a reminder, we use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your authorization requests.
Preview questionnaires
You can access preview questionnaires at ereferrals.bcbsm.com. They show the questions you'll need to answer in the actual questionnaires that open in the e-referral system. This can help you prepare your answers ahead of time.
To find the preview questionnaires:
- For BCN: Click BCN and then click Authorization Requirements & Criteria. Scroll down and look under the "Authorization criteria and preview questionnaires" heading.
- For Medicare Plus Blue: Click Blue Cross and then click Authorization Requirements & Criteria. In the "Medicare Plus Blue members" section, look under the "Authorization criteria and preview questionnaires - Medicare Plus Blue" heading.
Authorization criteria and medical policies
The pertinent authorization criteria and medical policies are also available on the Authorization Requirements & Criteria page.
*CPT codes, descriptions and two-digit modifiers only are copyright 2020 American Medical Association. All rights reserved.
Posted: June 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network