Updated clinical documentation requirements for musculoskeletal procedures

We recently published updated information about the clinical documentation you must include when submitting prior authorization requests to TurningPoint Healthcare Solutions LLC.

We updated or added information related to the specific clinical documentation requirements for:

• Conservative therapies
• Body mass index
• Smoking status
• Surgical plan

To view the updated requirements, see the Clinical documentation requirements for musculoskeletal procedures document, which is available on the Musculoskeletal Services pages of this website.

As a reminder, TurningPoint manages authorizations for orthopedic, pain management and spinal procedures for the following:

• Blue Cross commercial - All fully insured groups, select self-funded groups and all members with individual coverage
• Medicare Plus Blue^SM members
• BCN commercial members
• BCN Advantage^SM members

Posted: April 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network