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June 2007

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NetworkBlue

Secure preauthorization before rendering advanced imaging services for BlueOptions members

New BlueOptions copay required for advanced imaging services

Health Options

Retrospective requests no longer accepted for HMO advanced imaging services

All Provider Networks

Change in coding edits will affect payment for multiple imaging services

Diagnostic Imaging Utilization Management Program
Beginning July 2, 2007, ordering and performing NetworkBlue physicians and providers must obtain preauthorization prior to rendering diagnostic imaging services for BlueOptions members.

Multiple Imaging Coding Edit Change
What is the Multiple Imaging Coding Edit?

BCBSF will implement a coding edit that will apply a payment reduction when multiple images from the same diagnostic imaging family are provided during a single patient session. The payment reduction applies to second and subsequent procedures.