MEDICAL BILLING AND CODING UPDATES

Fecha: 03/06/24

This is to announcement is to notify you of prior authorization rule updates that will go into effectfor all lines of business and all products effective 7/01/2024. 

The following new CPT Proprietary Laboratory Analyses (PLA) codes and CPT Category IIIcodes will require prior auth, unless determined to be a non-covered service, upon their effectivedate of 7/1/2024. For other established codes, please use the Pre-Auth Check Tools on ourwebsite to confirm if the code(s) requires prior authorization. Prior authorization requirementsvary based on the line of business, so please select the applicable Pre-Auth Check Tool by the line of business. 

For questions or additional information, please contact your Provider Engagement Administrator for your product.