Name of Manual - Blue Cross and Blue Shield of Minnesota

Blue Plus
Referral Not Required We do not require referrals for the services listed below. Claims
will process at the highest level of coverage, as if they were
referred, without you authorizing a referral. This process is known
as a referral bypass or referral exception. The referral bypasses
may be in place for ease of administration, legislative mandate or
both. They may vary by employer contract or PCC. For complete
information about Minnesota Health Care Programs requirements,
see Chapter 3 in the Blue Plus Provider Manual.
• Abortion and sterilization
• Allergy serum when injection is done in the PCC
• Ambulance transportation
• Anesthesia and assistant surgeon, if medically necessary (if the
outpatient surgery or inpatient admission is referred)
• Covered services by dentists, endodontists, periodontists,
orthodontists, prosthodontists, and oral and maxillofacial
surgeons.
• Diagnostic X-ray and laboratory services only (except MRI)
• Durable medical equipment (DME)
• Emergency services
• Inpatient consultation (if the inpatient admission is referred)
• Inpatient consultation (if the inpatient admission is referred)
• Inpatient delivery/maternity, and related services, including
prenatal and complications of pregnancy
• Inpatient treatment of a medical emergency
• Magnetic Resonance Imaging (MRI)
6-14 Blue Cross Blue Shield of Minnesota Provider Policy and Procedure Manual (12/27/10)