Prior authorization

On August 1, exempt OPDs will receive an additional documentation request (ADR) for a 10-claim post-pay sample on finalized claims with dates of service on or after January 1, through June 30. Review…

For any service or item to be covered by Medicare, it must be eligible for a defined Medicare benefit category, be reasonable and necessary for the diagnosis or treatment of illness or injury or to…

For any service or item to be covered by Medicare, it must be eligible for a defined Medicare benefit category, be reasonable and necessary for the diagnosis or treatment of illness or injury or to…

CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.

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.

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.

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.

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.

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…

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…