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Commercial only electroconvulsive therapy (ect) request form: You must submit the predetermination to the blue. Web the recommended clinical review (predetermination) process is a service bcbsil offers so you can submit your claims with confidence. Web the predetermination process is a service blue cross and blue shield of illinois (bcbsil) offers so you can submit your claims with confidence that the proposed.
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Web procedure (cpt)/hcpcs codes for requested services along with icd10 diagnosis codes must be listed on the form.