Medical review

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Botulinum toxin injections

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Vein ablation and related services

Vein ablation and related services; some patients may want varicose vein treatment for cosmetic reasons. Medicare does not cover cosmetic surgery or expenses incurred in connection with such surgery.

Blepharoplasty, eyelid surgery, brow lift, and related services

Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly for cosmetic reasons. Functional or reconstructive eyelid surgery is…

Blepharoplasty, eyelid surgery, brow lift, and related services

Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly for cosmetic reasons. Functional or reconstructive eyelid surgery is…

Rhinoplasty and related services

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

Vein ablation and related services

Vein ablation and related services; some patients may want varicose vein treatment for cosmetic reasons. Medicare does not cover cosmetic surgery or expenses incurred in connection with such surgery.

Understanding repetitive scheduled non-emergent ambulance transports

Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.

Targeted probe and educate (TPE) round results: Wound care (CPT 11042 and 11045)

View targeted probe and educate (TPE) round results for wound care (CPT 11042 and 11045).