Blue Cross Complete Neuropsychological Testing Guideline Summary
Blue Cross Complete conducts prior authorization review for neuropsychological testing under the following conditions:
- If it is part of the psychological evaluation for bariatric surgery.
- If it is part of the psychological evaluation for transgender surgery.
- To rule out a diagnoses related to organic brain syndrome. (ex. Memory loss and dementia.)
- To rule out pseudo seizures.
- Residents within the city of Flint who have elevated lead serum levels.
If a case doesn’t meet the criteria noted above (including children under 21 years), providers are required to contact their local Pre-Paid Inpatient Health Plans. As a reminder, an authorization review or approval does not guarantee payment. Providers are responsible for meeting all claims and billing criteria.
Click here to read the full announcement sent out by Blue Cross Complete.