All PlansPrior AuthMedium impact
Medical Policy and Coding Updates - December 2018
Premera Blue Cross·WA · Pain Management, Vascular Surgery, Neurology +4 more·Medical Policy
Effective date
Feb 1, 2019
We identified it
Jun 18, 2026
Summary
Multiple policy updates effective at different dates including new prior authorization requirements for certain procedures, updated AIM clinical guidelines for radiation oncology and cardiology, genetic testing review transitions to AIM, and new drug coverage criteria. Key changes include prior auth for ablative treatments and mechanochemical vein procedures.
Action Required
By December 6, 2018: Billing team must update system to require prior authorization for CPT 64600 and 62281 for ablative treatments. By December 1, 2018: Update system to flag CPT 36473 and 36474 as investigational requiring review. By January 4, 2019: Transition genetic testing prior auths from Premera to AIM Specialty Health system. Update encounter forms and notify providers of new requirements.