What’s Changing: Blue Cross and Blue Shield of Oklahoma is changing prior authorization requirements for Medicare Advantage members to reflect new, replaced or removed codes due to updates from Utilization Management or the American Medical Association. A summary of changes is included below.
Important Reminder: Always check eligibility and benefits first through the Availity® Essentials Provider Portal or your preferred vendor portal, prior to rendering services. This step will confirm prior authorization requirements and utilization management vendors, if applicable.
Changes Include:
- Jan 1, 2024 – Removal of Magellan Electro Convulsive Therapy codes previously reviewed by BCBSOK
- April 1, 2024 – Addition of lab codes reviewed by eviCore healthcare
More Information: For a complete and up-to-date list of codes, go to our provider website in the Utilization Management section.
CPT copyright 2022 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.
Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.
eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSOK. eviCore is wholly responsible for its own products and services. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.