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Medicare Advantage: Changes to Precertification Procedures for Advanced Imaging Services

May 08, 2014

BlueCross BlueShield of South Carolina Medicare Advantage beneficiaries no longer require precertification for advanced imaging services from National Imaging Associates (NIA) when performed and billed in an outpatient or office location, effective January 1, 2014. NIA is an independent company that handled precertification for certain imaging services on behalf of BlueCross.

You can identify Medicare Advantage beneficiaries by the ZCT alpha-prefix on the beneficiary's insurance card. In general, these services do not require precertification:

  • Non-emergency Computed Tomography (CT) scans
  • Magnetic Resonance Imaging (MRI) scans
  • Magnetic Resonance Angiogram (MRA) scans
  • Positron Emission Tomography (PET) scans

Please do not submit requests for precertification of these advanced imaging services. They are no longer required.

For more information, contact Provider Education at 803-264-4730 or email Provider.Education@bcbssc.com.

Thank you for your attention to this policy change. We encourage you to share this message with everyone in your office.

 

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