2027 FEP Prior Authorization Code update

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers, effective Jan. 1, 2027, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Positron Emission Tomography (PET) scans will require prior authorization for all Federal Employee Program (FEP) plans. This is a change from 2026, where only Blue Focus plans required prior authorization.

Below is the list of codes that will not require prior authorization for FEP plans.

CT codes

• 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 71250, 71260, 71270, 71271, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72192, 72193, 72194, 73200, 73201, 73202, 73700, 73701, 73702, 74150, 74160, 74170, 74176, 74177, 74178, 74261, 74262, 74263, 75571, 75572, 75573, 76380, 76497

MRI codes

• 70336, 70540, 70542, 70543, 70551, 70552, 70553, 70554, 70555, 70557, 70558, 70559, 71550, 71551, 71552, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72195, 72196, 72197, 73218, 73219, 73220, 73221, 73222, 73223, 73718, 73719, 73720, 73721, 73722, 73723, 74181, 74182, 74183, 74712, 74713, 75557, 75559, 75561, 75563, 75565, 77046, 77047, 77048, 77049, 77084, 76390, 76498, 78072, C8903, C8905, C8906, C8908, S8035, S8037

PET Codes

• 78429, 78430, 78431, 78432, 78433, 78434, 78459, 78491, 78492, 78608, 78609, 78811, 78812, 78813, 78814, 78815, 78816, 78830, 78832, 78835, G0219, G0235, G0252, C9762, C9763

Providers will continue submitting prior authorization through Availity Essentials as they do today.

Questions?
Contact FEP Provider Services at 800-548-4026.