Prior Authorization Change for Implantable Loop Recorders

Date: 02/18/21

The following is an important change to our prior authorization (PA) requirements applicable to services rendered to MHS Health Wisconsin’s and Network Health’s BadgerCare Plus and SSI members.

The equipment code for implantable loop recorders, E0616, is already on PA; however, the insertion of this device is not. Given the invasiveness of this procedure and the current process to review for the device itself, insertion should align to require prior authorization. The CPT code listed below billed on a claim will require prior authorization to be paid.

The specific CPT code requiring PA:
Implantation procedure for implantable loop recorders: 33285

This change will be effective 3/1/2021.

Thank you for helping us to transform the health of the community one person at a time. If you have questions about this change in policy or anything else, please call MHS Health Provider Services at 1-800-222-9831.