procedure code 99236 — prior authorization under Blue Cross Blue Shield
Billing code 99236 · Category: inpatient
In our reference, this procedure typically requires prior authorization.
Typical turnaround is 1 day(s); Blue Cross Blue Shield's
standard turnaround is 14 calendar days (72 hours if urgent).
How to submit
Availity portal, State BCBS portal
Documentation typically required
Clinical notes
Observation order
Common reasons this gets denied
Outpatient setting appropriate
Insufficient acuity
Blue Cross Blue Shield-specific notes
PA requirements vary by state BCBS plan
BlueCard program — out-of-area may need host plan PA
FEP has own PA requirements
Many state plans use AIM/eviCore for imaging
Coverage limits: this page does not confirm authorization for any specific member's plan, and does not cover state-specific plan variants, out-of-network requests, or every payer x procedure pair in existence. For a definitive answer, contact Blue Cross Blue Shield directly using the submission method above.
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