Musculoskeletal Services Management CPT and HCPCS Codes (prior authorization requirement)
Governs prior authorization requirements for a long list of CPT and HCPCS codes for pre-scheduled inpatient and outpatient musculoskeletal services for Blue Cross Blue Shield of Massachusetts commercial (HMO, PPO) and Medicare Advantage members; commercial indemnity is excluded.
Effective April 1 2023, prior authorization will be required for the listed CPT and HCPCS codes for inpatient and outpatient pre-scheduled musculoskeletal services for commercial (HMO, PPO) and Medicare Advantage members.
Clarified coding information (multiple dates listed including 9/2025, 7/2025, 4/2025, 2/2025, 7/2024, 5/2024, 3/2023, 5/2023, 4/2023).
Policy clarified to add codes 27415, 27416, 29866, 29867 from retired MP 111; code 28446 will no longer require authorization effective 3/1/2025 and is a covered service.
Several musculoskeletal medical policies retired effective April 1, 2023 and will no longer be available on the Blue Cross website.
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