Surgical Services Requiring Precertification
Customize your policy alerts
Sign up for blue cross blue shield - minnesota Policy PRV20271MN-2502 alerts
Get alerted when Policy PRV20271MN-2502 changes without checking for updates manually.
Monitor payer policy activity
Lists CPT (and related) procedure codes that require precertification from Blue Cross Blue Shield of Minnesota for surgical services effective April 1, 2025; applies to providers and claims subject to this payer policy.
No material clinical or coverage changes in this revision.
Precertification Requirements
Precertification criteria
Listed CPT/HCPCS procedure codes require precertification as indicated; effective dates, code additions, deletions, and mappings are shown below.
Policy details
- Document lists code additions and deletions with various effective dates (examples include additions effective April 1, 2024; January 1, 2022; January 1, 2023; April 1, 2023; January 1, 2025).
- The policy explicitly states code deletions and additions across different effective dates (for example: code deletions effective December 31, 2021; code additions effective October 1, 2023; and other dated changes referenced).
Examples of listed CPT codes
Example CPT / HCPCS Codes
What Providers Must Do
Precertification required for listed surgical services (effective Apr 1, 2025)
Precertification is required for the surgical services and procedure codes listed in this policy, effective April 1, 2025. Providers must obtain administrative prior authorization from Blue Cross Blue Shield of Minnesota before performing any listed procedures on or after that date.
- Effective date: April 1, 2025
- Requirement: Precertification (administrative prior authorization) must be obtained for procedures listed in this policy
Key Definitions
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.