Prior authorization for hospital outpatient department services: Don’t wait too long to submit your prior authorization requests
When submitting prior authorization requests, be aware of response timeframes and documentation guidelines.
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Prior authorization requests (PARs): How to avoid potential non-affirmations
When submitting a prior authorization request (PAR), be mindful of specific guidelines relating to proper submission to avoid...
Ambulance physician certification statement
Physician certification statements (PCS) are required for patients who are under the direct care of a physician and are required...
Provider documentation tool for non-emergent ambulance transportation
This article is designed to assist medical providers with documenting the beneficiary’s medical condition supporting coverage...
Facet joint interventions for pain management
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the...
Prior authorization: Facet joints and cervical fusion
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn...
Prior authorization of ambulance claims requires UTN in proper field
Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a...
Botulinum toxin injections
Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and...
Cervical fusion with disc removal
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain...