Administrative Policy effective January 1, 2020

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Musculoskeletal Preauthorization Program Update

We would like to provide you with information regarding our Musculoskeletal Preauthorization Program through eviCore healthcare, which became effective with dates of service on or after February 1, 2019, for commercial, Medicare Advantage and Essential Plan lines of business when the member benefit requires preauthorization. EviCore healthcare an independent company contracted to provide utilization management services for Univera Healthcare.

Additional arthroscopy procedures impacting hip and knee surgeries will be added to the preauthorization program effective with dates of service on or after August 1, 2019. Please see the reverse of this notice for a list of the additional arthroscopy codes and corresponding descriptions.

A complete list of CPT codes for services requiring preauthorization will be available in the Referrals and Authorizations section of our website prior to August 1 and will include the newly added codes shaded in gray.

Please share this important information with all practice locations. If you have questions, contact your Provider Relations representative.

Additional arthroscopy codes chart

 

 
 
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