AmeriHealth currently requires precertification through CareCore National,
LLC d/b/a eviCore healthcare (eviCore) for
outpatient, non-emergent radiation therapy services for commercial members.
Effective January 1, 2017, the following procedure codes
will require precertification:
- C2616: Brachytherapy source, non-stranded, yttrium-90, per
source
- Q3001: Radioelements for brachytherapy, any type, each
Medical Policy #09.00.56c: Radiation Therapy Services was updated to reflect
the addition of the above procedure
codes and was posted as a Notification on September 30, 2016, and will become
effective on January 1, 2017.
To view the Notification for this policy, visit our Medical Policy Portal and select
Accept and Go to Medical Policy Online. Then select
Commercial under Active
Notifications.
If you have any questions, please contact your Provider Partnership
Associate or Network Coordinator.