Prior authorization
Prior Authorization Program for Repetitive Scheduled Non-Emergent Ambulance Transport
Review this overview of the prior authorization program for repetitive scheduled non-emergent ambulance transport (RSNAT).
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 paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code…
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 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 multiple or staged procedures, as well as best practices, tips and…
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 multiple or staged procedures, as well as best practices, tips and…
Rhinoplasty and Related Services
Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.
Cervical Fusion with Disc Removal
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…
Hospital Outpatient Department Prior Authorization Exemption Process
On August 1, exempt OPDs should have received 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…
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 paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code…
Cervical Fusion with Disc Removal
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…