Prior Authorization Guidelines - Blue Cross NC

~ Prior Authorization Guidelines ~Services marked by a bullet in the columns to the left require Prior Authorization for the designated line of business. For Specific Codes Requiring PA, please go to: Procedures (or those potentially cosmetic), such as but not limited to:ggAbdominoplasty ggBlepharoplasty ggBreast ReductiongDental ServicesgDiagnostic TestingggNeuropsychological TestingggPsychological Evaluations for medical conditionsggDurable Medical Equipment (See Prosthetics listed separately below) ggAll Rental Items ggItems > $ (Purchase) ggDME Maintenance or Repair ggHome Health ServicesggInpatient AdmissionsggScheduled admissions, including acute hospital, acute to acute hospital transfers, rehabilitation facility, hospice and skilled nursing facility : For urgent/emergency admits (including obstetric admits), Prior Authorization is NOT required.

~ Prior Authorization Guidelines ~ Services marked by a bullet in the columns to the left require prior authorization for the designated line of

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