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Blue Cross and Blue Shield of LouisianaCommercial · Prior Auth · Provider News · LAMedium impact

Network News - 2nd Quarter 2024

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Already effective July 1, 2024, Carelon Medical Benefits Management manages review of outpatient genetic testing, and all providers who request genetic testing must submit pre-service reviews to Carelon for dates of service on or after that date. For COVID-19, RSV and flu testing, providers may submit separate codes 87635, 87634 or 87502, or a combined assay code 87636 or 87637, and for separate individual codes only one code is reimbursed. Already effective April 1, 2024, code A9293 is used instead of A9279 for the Natural Cycles application for contraception.

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What to do

Action · 6 steps
01Already effective July 1, 2024: Submit pre-service reviews to Carelon for all outpatient genetic testing for dates of service on or after that date.
02Requests and order number verifications must come from the ordering provider, either online through iLinkBlue in the Carelon Authorizations application or by calling Carelon at 1-866-455-8416.
03Already effective April 1, 2024: Use code A9293 instead of A9279 for the Natural Cycles application for contraception.
04Billing team: When testing for any combination of COVID-19, RSV and flu, submit separate codes or a combined assay code, and note that for separate individual codes only one code will be reimbursed.
05Services rendered by providers in the network must be billed under their own provider number, not a supervising practitioner's number.
06Check current applicability of these items before acting, since the dates have passed.

Codes mentioned

8763587634875028763687637A9293A9279

Original notice

Network News - 2nd Quarter 2024
providers.lablue.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross and Blue Shield of Louisiana changes →
Network News - 1st Quarter 2018MediumEffective Mar 1, 2018 · Provider NewsNetwork News - 2nd Quarter 2020MediumEffective Jan 1, 2021 · Provider NewsNetwork News - 2nd Quarter 2015MediumNo effective date · Provider NewsNetwork News - 2nd Quarter 2016MediumNo effective date · Provider NewsBrowse every Blue Cross and Blue Shield of Louisiana change in the policy list

Related policy hubs

Blue Cross and Blue Shield of Louisiana policiesLA policy changesCode 87635Code 87634Code 87502Code 87636Code 87637Code A9293Code A9279

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