Triad Musculoskeletal Program - Tennessee

Update January 23, 2013.

Effective February 1, 2013, the CT or MRI associated with the following joint arthrogram procedures (23350, 27093, 27095, 27370, G0259 and G0260) will also be authorized through the BCBST Musculoskeletal Program (administered by Triad Healthcare).

Pain Management, Spine and Joint surgery, Physical Medicine

Triad has partnered with Blue Cross Blue Shield of Tennessee (BCBST) to administer its prior authorization program for Pain Management, Spine and Joint surgery (limited to Knee, Hip and Shoulder) services for Commercial, Fully Insured, Medicare Advantage and PPO members. Triad will also administer a Physical Medicine program including Chiropractic, Physical and Occupational Therapy services for BCBST Medicare Advantage members only.

Arthrograms that include High Tech Imaging

As of 2/1/13, Triad will manage shoulder, hip and knee CT/MRI’s when rendered in conjunction with joint arthrography. Please note when rendering High Tech Imaging procedures without joint arthrography you will continue to follow the existing prior authorization process for imaging.
Click here for list of procedure codes

Prior Authorization

Effective 03/15/12, the following procedure codes require prior authorization: Click here for list of procedure codes

Prior authorizations can be submitted electronically, with medical records, through BCBST BlueAccess® by clicking here: https://www.bcbst.com/providers/ or faxed directly to Triad at 1-800-520-8045.

Pain Management, Spine and Joint surgery, Physical Medicine Prior authorization forms can be accessed here: Click here for the Prior Authorization Form

Please note: medical records must accompany all prior authorization requests.

Home Health Services

As of 12/01/2012 BCBST has elected to expand its current MSK program administered by Triad Healthcare to include Home Health Services delivered by Physical and Occupational Therapist. Please note any request for prior authorization for services need to be requested as Home Health Physical Therapy and/or Occupational Therapy and denote number of visits for each service requested.

Prior Authorization

Prior authorizations can be submitted electronically, with medical records, through BCBST BlueAccess® by clicking here: https://www.bcbst.com/providers/ or faxed directly to Triad at 1-800-520-8045.

Home Health Prior authorization form can be accessed here: Click here for the Home Health Prior Authorization Form.

Please note: medical records must accompany all prior authorization requests.

Medical Policies

Triad Medical Policies can be accessed here: Click here for medical policies

General Information

Customer Service: Triad’s Customer Service number is 1-800-388-8978. Hours of Operation are Monday through Friday 8am-6pm EST.

Peer to Peer (P2P): If you wish to speak with a Clinical Peer at anytime, please call Triad’s Customer Service
at 1-800-388-8978 and a Representative can assist you.



BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association