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Musculoskeletal Program Updates: April 2020

Horizon BCBSNJ collaborates with eviCore healthcare (eviCore) to administer our Musculoskeletal Program. In March 2020, the new-for-2020 procedure codes listed below will be included as part of our Musculoskeletal Program.

MUSCULOSKELETAL PROGRAM FOR SPINE SURGERY SERVICES
Beginning with services to be provided on and after April 1, 2020, eviCore will conduct Prior Authorization and/or Medical Necessity Determination (PA/MND) reviews for the following additional service:

  • C9757

MUSCULOSKELETAL PROGRAM FOR PAIN MANAGEMENT
Beginning with services to be provided on and after April 1, 2020, eviCore will conduct PA/MND reviews for the following additional services:

  • 64451
  • 64625

Learn more about our Musculoskeletal Program or review the complete lists of spine surgery services and pain management services for which eviCore conducts PA/MND on our behalf as part of this program.

If you have questions, please contact your Network Specialist.

Published on: February 24, 2020, 02:23 a.m. ET
Last updated on: February 24, 2020, 02:37 a.m. ET