Summary
Blue Cross requires prior authorization for fractional flow reserve using CT (FFR-CT) procedures for dates of service on and after June 15, 2019, and FFR-CT procedures performed without a prior authorization are subject to penalties. The requirement applies to Preferred Care PPO, HMO Louisiana, Blue Connect, Community Blue, Signature Blue and Office of Group Benefits members, and AIM Specialty Health administers the program. The newsletter also lists telemedicine codes added to billing guidelines effective January 1, 2019, requires Modifier 95 or GT for telemedicine delivered in real time, and states that a universal prior authorization form is required for prescription drug authorization requests effective January 1, 2019.
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