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December 2020

New questionnaires for Blue Cross commercial, Medicare Plus Blue plans

Starting in January 2021, Blue Cross Blue Shield of Michigan will implement new questionnaires for Blue Cross Blue Shield of Michigan commercial and Medicare Plus Blue℠ members when authorizations are entered into the e-referral system.

The questionnaires will focus on when an inpatient setting code isn’t used (e.g., *99221-*99239) for inpatient surgical procedures. Health care providers will be asked to attest that benefits and eligibility for the procedures entered have been verified. If the benefits and eligibility haven’t been verified, our utilization management team will review the authorization request and contact the facility.

These questionnaires will be similar to the questionnaires for Blue Care Network commercial and BCN Advantage℠ members.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2019 American Medical Association. All rights reserved.