BlueCross BlueShield of Western New York
Welcome to the BlueCross BlueShield of Western New York page. Here you can download clinical guidelines, policies and procedures specific to both ordering providers and radiation oncology facilities. These include quick reference guides and FAQs. You can also view information designed to assist you in using the RadMD Web site to obtain and check authorizations.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Charmaine Everett.
Update on COVID-19
Radiation Oncology Benefits Management
Effective November 1, 2019, Radiation Treatment preauthorization requests for all types of cancer and conditions should be submitted through Magellan Healthcare for BlueCross BlueShield of Western New York Commercial and Medicare Advantage membership.
Clinical Guideline
Treatment Plan Checklists
- Anal Cancer
- Bone Metastatic Cancer
- Bone Primary Cancer
- Breast Cancer
- Central Nervous System (CNS) Metastatic Cancer
- Central Nervous System (CNS) Primary Cancer
- Cervical Cancer
- Colon Cancer
- Endometrial Cancer
- Gastric Cancer
- Head and Neck Cancer
- Hodgkins Lymphoma
- Non-Hodgkins Lymphoma
- Lung Cancer (Non-Small Cell)
- Lung Cancer (Small Cell)
- Other Condition
- Other Metastatic Cancer
- Pancreas Cancer
- Prophylactic Cranial Irradiation
- Prostate Cancer
- Rectal Cancer
- Skin Cancer
CPT4 Codes and Covered Procedures
- BlueCross BlueShield of Western New York Radiation Oncology Claims Resolution Matrix 2020
- BlueCross BlueShield of Western New York Claims Resolution Matrix -2020
Program and Provider Education
- BlueCross BlueShield of Western New York Quick Reference Guide
- BlueCross BlueShield of Western New York Frequently Asked Questions
- BlueCross BlueShield of Western New York Provider Education Presentation
- BlueCross BlueShield of Western New York Training Evaluation Form
- BlueCross BlueShield of Western New York Radiation Therapy Treatment Notification Form
RadMD User References
Radiology Benefits Management Program
RadMD User References
Clinical Guideline
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by NIA