Changes to the Certification for 2012
Posted 07/27/11, Modified 02/02/12
For charges incurred on or after January 1, 2012, HealthChoice made some changes to its current list of procedures and/or services that require certification.
The following will be added to the list of services requiring certification:
- Spinal Cord Stimulator Placement Surgery (CPT Codes 63650, 63655, 63661, 63662, 63663, 63664, 63685 and 63688 and HCPCS Codes L8682, L8685, L8686, L8687 and L8688)
The following have been removed from the list of services requiring certification:
- PET Scans for Tumor Imaging (CPT Codes 78811, 78812, 78813, 78814, 78815 and 78816)
- Speech Therapy for plan members and their covered dependents 18 years of age or older (CPT Codes 92507 and 92508 and HCPCS Codes S9128 and S9152)
- Xolair Injection, omalizumab 5mg (J Code J2357)
Note: All CPT/HCPCS codes are subject to change.
Please direct questions about the certification process to the HealthChoice Network Management/Provider Relations Division at 1-405-717-8790 or toll-free 1-800-543-6044. Questions can also be sent to Provider Relations by email to firstname.lastname@example.org.