March 23, 2021
What’s Changing: Blue Cross and Blue Shield of Illinois (BCBSIL) is removing the prior authorization requirement through AIM effective April 1, 2021, for six “Musculoskeletal” codes for commercial non-HMO members.
Current Procedural Terminology (CPT®) Code |
Description |
29892 |
ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX |
23700 |
MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS |
27331 |
ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB |
27405 |
RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL |
27407 |
REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT |
27409 |
RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE |
More Information: Refer to the updated Commercial Outpatient Medical Surgical Prior Authorization Code List in theUtilization Management section. The above codes are designated “Removed from 04/01/2021 update release. No PA required.”
Important Reminder: Always check eligibility and benefits first through the Availity® Provider Portal or your preferred vendor portal, prior to rendering services. This step will confirm prior authorization requirements and utilization management vendors, if applicable.
CPT copyright 2020 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined 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 coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSILAIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity or AIM. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.