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Surgical Services

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

  • Blepharoplasty, brow lift or ptosis repair
  • Breast repair and/or reconstruction
  • Gastric restrictive procedures (if covered by the group plan)
  • Implantable bone conduction hearing aids
  • Knee arthroplasty
  • Lumbar spinal fusion
  • Reduction mammoplasty
  • Rhinoplasty
  • Surgery for obstructive sleep apnea
  • Surgery for varicose veins
  • Wireless capsule endoscopy

View a list of procedure codes for 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.

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