There are important changes to the prior authorizationrequirements for Blue Cross Community Centennial Members.
Beginning September 1, 2020, the following changes will be madeto the Blue Cross Community Centennial Prior Authorization Grid:
Código |
Prior Authorization Source |
Cambiar |
Fecha de vigencia |
---|---|---|---|
63688 |
BCBSNM |
remove |
9/1/2020 |
C9024 |
BCBSNM |
remove |
9/1/2020 |
C9028 |
BCBSNM |
remove |
9/1/2020 |
C9030 |
BCBSNM |
remove |
9/1/2020 |
C9032 |
BCBSNM |
remove |
9/1/2020 |
C9467 |
BCBSNM |
remove |
9/1/2020 |
C9492 |
BCBSNM |
remove |
9/1/2020 |
C9493 |
BCBSNM |
remove |
9/1/2020 |
C9016 |
BCBSNM |
remove |
9/1/2020 |
C9466 |
BCBSNM |
remove |
9/1/2020 |
97124 |
BCBSNM |
remove |
9/1/2020 |
Código |
Prior Authorization Source |
Cambiar |
Fecha de vigencia |
---|---|---|---|
0153U |
eviCore |
add |
9/1/2020 |
0156U |
eviCore |
add |
9/1/2020 |
0157U |
eviCore |
add |
9/1/2020 |
0158U |
eviCore |
add |
9/1/2020 |
0159U |
eviCore |
add |
9/1/2020 |
0160U |
eviCore |
add |
9/1/2020 |
0161U |
eviCore |
add |
9/1/2020 |
0162U |
eviCore |
add |
9/1/2020 |
0169U |
eviCore |
add |
9/1/2020 |
0170U |
eviCore |
add |
9/1/2020 |
0171U |
eviCore |
add |
9/1/2020 |
81277 |
eviCore |
add |
9/1/2020 |
81307 |
eviCore |
add |
9/1/2020 |
81308 |
eviCore |
add |
9/1/2020 |
81522 |
eviCore |
add |
9/1/2020 |
81542 |
eviCore |
add |
9/1/2020 |
81552 |
eviCore |
add |
9/1/2020 |
97124 |
BCBS |
remove |
9/1/2020 |
77399 |
eviCore |
remove |
9/1/2020 |
63688 |
BCBS |
remove |
9/1/2020 |
C9024 |
BCBS |
remove |
9/1/2020 |
C9028 |
BCBS |
remove |
9/1/2020 |
C9030 |
BCBS |
remove |
9/1/2020 |
C9032 |
BCBS |
remove |
9/1/2020 |
C9467 |
BCBS |
remove |
9/1/2020 |
C9492 |
BCBS |
remove |
9/1/2020 |
C9493 |
BCBS |
remove |
9/1/2020 |
C9016 |
BCBS |
remove |
9/1/2020 |
C9466 |
BCBSNM |
remove |
9/1/2020 |
76873 |
eviCore |
remove |
9/1/2020 |
76965 |
eviCore |
remove |
9/1/2020 |
77261 |
eviCore |
remove |
9/1/2020 |
77262 |
eviCore |
remove |
9/1/2020 |
77263 |
eviCore |
remove |
9/1/2020 |
77280 |
eviCore |
remove |
9/1/2020 |
77285 |
eviCore |
remove |
9/1/2020 |
77290 |
eviCore |
remove |
9/1/2020 |
77293 |
eviCore |
remove |
9/1/2020 |
77295 |
eviCore |
remove |
9/1/2020 |
77299 |
eviCore |
remove |
9/1/2020 |
77300 |
eviCore |
remove |
9/1/2020 |
77301 |
eviCore |
remove |
9/1/2020 |
77306 |
eviCore |
remove |
9/1/2020 |
77307 |
eviCore |
remove |
9/1/2020 |
77316 |
eviCore |
remove |
9/1/2020 |
77317 |
eviCore |
remove |
9/1/2020 |
77318 |
eviCore |
remove |
9/1/2020 |
77321 |
eviCore |
remove |
9/1/2020 |
77331 |
eviCore |
remove |
9/1/2020 |
77332 |
eviCore |
remove |
9/1/2020 |
77333 |
eviCore |
remove |
9/1/2020 |
77334 |
eviCore |
remove |
9/1/2020 |
77336 |
eviCore |
remove |
9/1/2020 |
77338 |
eviCore |
remove |
9/1/2020 |
77370 |
eviCore |
remove |
9/1/2020 |
77417 |
eviCore |
remove |
9/1/2020 |
77427 |
eviCore |
remove |
9/1/2020 |
77431 |
eviCore |
remove |
9/1/2020 |
77432 |
eviCore |
remove |
9/1/2020 |
77435 |
eviCore |
remove |
9/1/2020 |
77469 |
eviCore |
remove |
9/1/2020 |
77470 |
eviCore |
remove |
9/1/2020 |
77499 |
eviCore |
remove |
9/1/2020 |
77789 |
eviCore |
remove |
9/1/2020 |
77790 |
eviCore |
remove |
9/1/2020 |
77799 |
eviCore |
remove |
9/1/2020 |
81200 |
eviCore |
remove |
9/1/2020 |
81205 |
eviCore |
remove |
9/1/2020 |
81507 |
eviCore |
remove |
9/1/2020 |
C9408 |
eviCore |
remove |
9/1/2020 |
0104U |
eviCore |
add |
9/1/2020 |
0036U |
eviCore |
add |
9/1/2020 |
81362 |
eviCore |
add |
9/1/2020 |
81322 |
eviCore |
add |
9/1/2020 |
81293 |
eviCore |
add |
9/1/2020 |
81289 |
eviCore |
add |
9/1/2020 |
A9590 |
eviCore |
add |
9/1/2020 |
0172U |
eviCore |
add |
9/1/2020 |
0173U |
eviCore |
add |
9/1/2020 |
0175U |
eviCore |
add |
9/1/2020 |
0179U |
eviCore |
add |
9/1/2020 |
It is important to use Availity®, or your preferred vendor, to check eligibility and benefits,determine if you are in-network for your patient, and whether anypreauthorization or prenotification is required. Availity allows you todetermine if preauthorization is required. Refer to the Elegibilidad y beneficios web page for more information onAvaility. Providers can also refer to the Prior Authorization section Blue Cross Community Centennial web page for more information regarding prior authorizations.
Such services are funded in part with the state of New Mexico.
As a reminder, it is important to check eligibility and benefitsprior to rendering services. This step will help you determine if benefit priorauthorization is required for a particular member. For additional information,such as definitions and links to helpful resources, refer to the Eligibilityand Benefits section on BCBSNM's provider website.
Please note that verification of eligibility and benefits,and/or the fact that a service or treatment has been preauthorized orpredetermined for benefits is not a guarantee of payment. Benefits will bedetermined 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 coverageapplicable on the date services were rendered. If you have questions, contactthe number on the member's ID card.
Availity is a trademark of Availity, L.L.C., a separate companythat operates a health information network to provide electronic informationexchange services to medical professionals. Availity provides administrativeservices to BCBSNM.
BCBSNM makes no endorsement, representations or warrantiesregarding any products or services offered by Availity, or Medecision. Thevendors are solely responsible for the products or services they offer. If you haveany questions regarding any of the products or services they offer, you shouldcontact the vendor(s) directly.