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Network News - 4th Quarter 2023
Blue Cross and Blue Shield of Louisiana·LA · Sleep Medicine, Pulmonology·Provider News
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Blue Cross and Blue Shield of Louisiana is implementing a new Sleep Management Program requiring prior authorization through Carelon for all outpatient sleep testing and therapy services starting January 1, 2024. Multiple new CPT and HCPCS codes have been added to the system effective October 1, 2023.
Action Required
Before January 1, 2024: Billing team must update workflows to obtain prior authorization from Carelon for all sleep testing and therapy services (sleep studies, CPAP/APAP/BPAP devices, oral appliances, hypoglossal nerve stimulator) for fully-insured and Small Business Funded members. Starting December 18, 2023: Submit authorization requests to Carelon at 1-866-455-8416 or via iLinkBlue portal. Continue using Blue Cross for authorizations through December 31, 2023. Failure to obtain proper authorization will result in claim denials.