Precertification Changes

Precertification Changes

1/30/2019

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan no longer require precertification for the following codes:

  1. E0601 - Continuous Positive Airway Pressure (CPAP) 
  2. E0561 – Humidifier, Non-Heated, Used with Positive Airway Pressure Device 
  3. E0562 – Humidifier, Heated, Used with Positive Airway Pressure Device 
  4. G0378 - Hospital Observation Service, Per Hour

These changes are effective immediately and are applicable to all BlueCross and BlueChoice members, including Affordable Care Act (ACA) members. This change does not apply to Federal Employee Program (FEP) or State Health Plan members.

Please be sure to update your practice management systems to reflect this change.