Prior authorization codes
Blue Cross and Blue Shield of North Carolina
Active CPT codes that appear on the extracted prior authorization list for this health plan.
| Code | Procedure / Service | Effective | Revised | Confidence | Source |
|---|---|---|---|---|---|
| 0502F | • – reimbursement is $175.00 as a one-time retention incentive on or after the fifth visit | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 2310B | NM109 | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 25538 | • If you need further instructions, please contact the CBA provider contract specialist at 800-868-1032, ext | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 29202 | P.O. Box 100185, AX-315 | Columbia, SC | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 29260 | Columbia, SC -0601 | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 29405 | North Charleston, SC | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 32869 | Orlando, FL | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 38520 | • BlueCross | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 44730 | Provider Relations and Education provider.education@bcbssc.com Phone: 800-288-2227, ext | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 60094 | Palatine, IL -4467 | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 77828 | • Companion Life (Life insurance is offered by Companion Life. Because Companion Life is a separate | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 90791 | • CBA approves one initial evaluation ( or ) per provider per course of treatment | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 90792 | • CBA approves one initial evaluation ( or ) per provider per course of treatment | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 94467 | PO Box | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 99078 | • with TH modifier – reimbursement is $30.00 per visit, up to 10 visits total | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| 99211 | NTE*ADD*SERVICE LINE 1 – CHANGE PROCEDURE CODE TO ~ | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9137 | Adynovate Drug Name Old HCPCS Current HCPCS | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9474 | Darzalex Onivyde | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9476 | Darzalex Onivyde | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9477 | Empliciti Yondelis | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9478 | Bendeka Kanuma | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9480 | Empliciti Yondelis | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| C9620 | • New - , malignant mast cell neoplasm, unspecified | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| D8080 | o Submit one line with the banding fee code ( - ) and the charge for the banding | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| D8090 | o Submit one line with the banding fee code ( - ) and the charge for the banding | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| D8670 | o Submit one line with the monthly adjustment code ( ) and the total months of treatment and the | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| H0002 | • : Behavioral health screening — $24 reimbursement | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| H0004 | • : Behavioral health intervention — $48 reimbursement | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| H5412 | • Deleted - , Blindness, left eye, low vision right eye | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J2182 | Coagadex Nucala | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J2840 | Bendeka Kanuma | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J3490 | Coagadex Nucala | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J3590 | Coagadex Nucala | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J7175 | Coagadex Nucala | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J7207 | Adynovate Drug Name Old HCPCS Current HCPCS | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J9033 | Bendeka Kanuma | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J9034 | Bendeka Kanuma | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J9145 | Darzalex Onivyde | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J9176 | Empliciti Yondelis | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J9205 | Darzalex Onivyde | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |
| J9352 | Empliciti Yondelis | 2018-04-15 | Not listed | 97% | [PDF] 2018 Annual Provider Summit |