BlueCross BlueShield of South Carolina
Welcome to the BlueCross BlueShield of South Carolina page. Here you can access useful materials about the program.
Documents
- BlueCross BlueShield of South Carolina CPT Codes Matrix (PDF 495K)
- BlueCross BlueShield of South Carolina Quick Reference Guide (PDF 342K)
- BlueCross BlueShield of South Carolina Frequently Asked Questions (PDF 532K)
- RadMD for Ordering and Imaging Providers (PDF 96K)
- RadMD Quick Start Guide (PDF 451K)
- RadMD Upload Feature (PDF 438K)
Spine Care Program
Effective May 1, 2016, BlueCross and BlueChoice will implement a musculoskeletal program. This program includes prior authorization for two components of non-emergent musculoskeletal care: outpatient, interventional spine pain management services; and inpatient and outpatient lumbar and cervical spine surgeries.
The Call Center will be available beginning Monday, April 25, 2016, for prior authorization for dates of service May 1, 2016, and beyond.
- Blue Cross Blue Shield South Carolina MSK Letter
- Frequently Asked Questions- Interventional Pain Management
- Frequently Asked Questions-Lumbar and Cervical Surgeries
- MSK- Provider Training
- MSK-Quick Reference Guide
- BCBSSC and BlueChoice IPM and Spine Surgery Utilization Matrix
- Interventional Pain Management Checklist
- Spine Surgery Checklist
- Provider Webinar Education Invitation
- Surgery Quick Start Guide
- Pain Management - Injection Quick Start Guide
Clinical Guidelines
- Clinical Guidelines
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Refer to the Utilization Review Matrix document to view specific codes managed by NIA
Radiation Oncology
Effective January 1, 2015, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan/NIA Magellan will provide utilization management services for all outpatient radiation therapy for all cancer sites effective January 1, 2015.
Radiation Oncology Checklists
- Anal Cancer (PDF 324K)
- Bone Metastatic Cancer (PDF 392K)
- Bone Primary Cancer (PDF 375K)
- Breast Cancer (PDF 168K)
- Central Nervous System (CNS) Metastatic Cancer (Brain/Spine)
- Central Nervous System (CNS) Primary Cancer (Brain/Spine) (PDF 305K)
- Cervical Cancer (PDF 386K)
- Colon (PDF 129K)
- Endometrial Cancer (PDF 386K)
- Gastric Cancer (PDF 385K)
- Head and Neck Cancer (PDF 390K)
- Hodgkins Lymphoma (PDF 393K)
- Lung Cancer (Non-Small Cell) (PDF 126K)
- Lung Cancer (Small Cell) (PDF 127K)
- Non-Hodgkins Lymphoma (PDF 391K)
- Pancreas Cancer (PDF 381K)
- Prophylactic Cranial Irradiation
- Prostate Cancer (PDF 157K)
- Rectal (PDF 129K)
- Skin Cancer
- Other Cancer (PDF 397K)
- Other Metastatic Cancer (PDF 102K)
NIA Radiation Oncology Coding Standards
- Dosimetry Planning Coding Standard
- Image Guidance Coding Standard
- Physician Treatment Management Coding Standard
- Physics Coding Standard
- Simulation Coding Standard
- Treatment Devices Coding Standard
Radiation Oncology Management Educational Documents
- Radiation Oncology Utilization Review Matrix (PDF 531K)
- Radiation Therapy Treatment Notification Form for Transition Cases (PDF 536K)
- Radiation Oncology Announcement Letter (PDF 52K)
- Radiation Oncology Solutions Program (PDF 2,969K)
- Frequently Asked Questions For Radiation Oncologists and Cancer Treatment Facilities (PDF 134K)
- Radiation Oncologists and Cancer Treatment Facilities Quick Reference Guide (PDF 111K)
- RadMD for Radiation Oncology Quick Start Guide (PDF 566K)