Resources

The following surgical services may require precertification for your Blue Cross patients:

• Balloon Ostial Dilation*
• Blepharoplasty, brow lift or ptosis repair
• Gastric restrictive procedures (if covered by the group plan)
• Gynecomastia Surgery*
• Implantable bone conduction hearing aids
• Knee arthroplasty
• Lumbar spinal fusion
• Panniculectomy/excision of redundant skin or tissue*
• Rhinoplasty
• Surgery for obstructive sleep apnea
• Surgery for varicose veins

*Effective October 1, 2023, precertification will be required for these services.

View a list of Surgical Services Requiring Precertification
 

To see if precertification is needed for a patient, check eligibility and benefits through ProviderAccess or your practice management software. If precertification is required, you can begin the process through Eligibility and Benefits or by going directly to Pre-Service Review and entering the specific procedure code for the service you plan to perform for the patient.

Medical Policies

• Surgical Policies
• Blue Advantage Surgical Policies

Resources

• Pre-Service Review FAQs