Radiation therapy services for A9590 require prior authorization for all Blue Cross, BCN members starting April 1

For dates of service on or after April 1, 2020, services associated with HCPCS code A9590 (iodine i-131, iobenguane, 1 millicurie) require prior authorization by eviCore healthcare.

This applies to all Blue Cross Blue Shield of Michigan and Blue Care Network members with plans subject to eviCore healthcare authorization requirements:

• Blue Cross’ PPO
• Medicare Plus Blue^SM PPO
• BCN commercial
• BCN Advantage^SM

We’ve updated the document titled Procedures that require authorization by eviCore healthcare to reflect this new requirement.

How to submit authorization requests

Submit authorization requests to eviCore in one of these ways:

• Preferred: Use eviCore’s provider portal at evicore.com.**
• Alternative: Call eviCore at 1-855-774-1317.
• Alternative: Fax to eviCore at 1-800-540-2406.

Additional information

For more information, refer to the document titled Frequently asked questions about requesting authorization from eviCore healthcare.

You can find this document and other resources on our ereferrals.bcbsm.com website:

• The Procedures Managed by eviCore for BCN webpage
• The Procedures Managed by eviCore for Blue Cross webpage

**Blue Cross and BCN don’t own or control this website.