PA Resources Portlet

Resources

CODING & DOCUMENTATION

EDUCATION & EVENTS

ENROLLMENT & CREDENTIALING

FORMS & MANUALS

PATIENT HEALTH

PHARMACY

POLICIES & GUIDELINES

PRE-SERVICE REVIEW

PROGRAMS & INITIATIVES

PROVIDER eSOLUTIONS

PROVIDER NETWORKS & SPECIALTIES

PA Dynamic Rendering

Back

Surgical Services

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

Resources