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COVID-19

Cardiac Services

TurningPoint is contrracted to review PA/MND for certain cardiac services, many of which require the use of an implantable device.

Review the procedures subject to PA/MND as part of our Surgical and Implantable Device Management Program for Cardiac Services.

Members included in this program for cardiac services

  • Horizon fully insured or level-funded plans/products including those members enrolled in plans that include BlueCard® benefits for care received outside of our local service area.
  • State Health Benefits Program (SHBP)/School Employees’ Health Benefits Program (SEHBP) plans/products
  • Federal Employee Plans® (FEP®).
  • You can determine member eligibility and benefits by calling the phone number on the back to the member’s ID card. For BlueCard benefits, call 1-800-676-2583.

    TurningPoint will NOT review PA/MND f services to be provided to members enrolled in self-insured Administrative Services Only (ASO) plans as part of this program.

    Resources

    Surgical and Implantable Device Management Program for Cardiac Services Procedure Code Listing
    Cardiac Services Medical Policy Criteria and Guidelines

    CPT® is a registered trademark of the American Medical Association.
    NaviNet® is a registered trademark of NaviNet, Inc.
    TurningPoint Healthcare Solutions, LLC supports Horizon Blue Cross Blue Shield of New Jersey in the administration and utilization management review of certain orthopedic and cardiac services for coverage. TurningPoint Healthcare Solutions, LLC is independent from, and not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross Blue Shield Association.