Medical review

Use these checklists to ensure you have met medical documentation requirements based on specific services.

Use these checklists to ensure you have met medical documentation requirements based on specific services.

Review this overview of the prior authorization program for repetitive scheduled non-emergent ambulance transport (RSNAT).

Repetitive scheduled non-emergent ambulance transport prior authorization request submission requires the following items to facilitate the processing of initial or resubmission requests.

Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…

This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and…

Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and…

Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code…