Cardiac Services

Effective July 1, 2022, Horizon BCBSNJ collaborates with TurningPoint to conduct PA/MND review for certain cardiac services, many of which require the use of an implantable device for services to be provided to members enrolled in Horizon BCBCNJ Medicaid, FIDE-SNP and MLTSS plans.

TurningPoint will not conduct PA/MND reviews of services that are to be provided to members enrolled in ABD or MLTSS plans for whom Medicare is the primary payer.

You can determine member eligibility and benefits by calling the phone number on the back to the member’s ID card.

eviCore Cardiology Program changing
For services to be provided July 1, 2022 and after, eviCore HealthCare will no longer manage cardiology codes that involve the use of an implantable device. Please do not submit requests to eviCore for review of cardiology codes that involve the use of the implantable devices for services to be rendered on and after July 1, 2022. eviCore will continue to review submitted requests for certain cardiology services that do not involve the use of an implantable device.

CPT® is a registered trademark of the American Medical Association.
NaviNet® is a registered trademark of NaviNet, Inc.
TurningPoint Healthcare Solutions, LLC supports Horizon Blue Cross Blue Shield of New Jersey in the administration and utilization management review of certain orthopedic, cardiac and spine-related services for coverage. TurningPoint Healthcare Solutions, LLC is independent from, and not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross Blue Shield Association.