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The Bridge Program

Learn how the Bridge Program applies to NYCE PPO, Large Group, and ASO plan members in 2026.

Preauthorization List Additions Starting July 1 and Oct. 13, 2023

Date Posted: August 29, 2023

 

Update: CPT Code 15834 (Excision, excessive skin, and subcutaneous tissue (includes lipectomy); hip) will not be added to the EmblemHealth Preauthorization List as originally announced below. We will continue to apply our Cosmetic and Reconstructive Surgery Procedures medical policy which lists CPT Code 15834 on Table 1 as a cosmetic procedure.

 

Originally Posted: 06/30/2023

 

The following tables shows the codes that will be added to the EmblemHealth Preauthorization List July 1 and Oct. 13, 2023.

The following codes are added to the EmblemHealth Preauthorization List starting July 1, 2023.

 

Code Added to the Preauthorization List Starting July 1, 2023

 

CPT/HCPCS Code

CPT Code Description

0388U

Oncology (non-small cell lung cancer), next-generation sequencing with identification of single nucleotide variants, copy number variants, insertions and deletions, and structural variants in 37 cancer-related genes, plasma, with report for alteration detection

0392U

Drug metabolism (depression, anxiety, attention-deficit/hyperactivity disorder [ADHD]), gene-drug interactions, variant analysis of 16 genes, including deletion/duplication analysis of CYP2D6, reported as impact of gene-drug interaction for each drug

0397U

Oncology (non-small cell lung cancer), cell-free DNA from plasma, targeted sequence analysis of at least 109 genes, including sequence variants, substitutions, insertions, deletions, select rearrangements, and copy number variations

0400U

Obstetrics (expanded carrier screening), 145 genes by next generation sequencing, fragment analysis and multiplex ligation dependent probe amplification, DNA, reported as carrier positive or negative

 

 

The following code will added to the EmblemHealth Preauthorization List starting Oct. 13, 2023.

Code Added to the Preauthorization List Starting Oct. 13, 2023

 

CPT/HCPCS Code

CPT Code Description

15834

Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip

 

JP 56610 8/23

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