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Updates to Medicare Advantage Prior Authorization Requirement Changes Effective April 1, 2023

Please note, this communication applies to Medicare Advantage offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).

On January 1, 2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) published the Prior Authorization list, which included several cardiac procedure codes for Prior Authorization (PA), effective April 1, 2023. To review CPT codes, please review the CPT Codes.

These codes for Medicare Advantage have been removed, and will not require PA at this time:

  • 93458
  • 33208
  • 37225
  • 37229
  • 93460
  • 93454
  • 92928
  • 37221
  • 37228
  • 93459
  • 37227
  • 37224
  • 93456
  • 92920
  • 93455
  • 93461
  • 92943
  • 93457

Not all PA requirements are listed here. Detailed PA requirements are available to contracted providers on our Provider Portal.