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 diagnosis 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 from Blue Cross Complete.