Medical documentation checklists
Use these checklists to ensure you have met medical documentation requirements based on specific services.
Articles
Article Type
Category
Prior Authorization Program for Certain Hospital Outpatient Department Services - Submitting the Prior Authorization Request
This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on...
Prior Authorization Program for Certain Hospital Outpatient Department Services - Claim Submission Guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any...
Cervical Fusion with Disc Removal
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain...
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...
Hospital Outpatient Department Prior Authorization Exemption Process
On August 1, exempt OPDs will receive an additional documentation request (ADR) for a 10-claim post-pay sample on finalized...
Rhinoplasty and Related Services
Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.
Prior Authorization Program Initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process...
Ambulatory Surgical Center Prior Authorization Request Submission Guidelines
View these submission guidelines for ASC prior authorization requests.
Prior Authorization Program for Certain Hospital Outpatient Department Services
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or...