Prior authorization
Prior authorization of ambulance claims requires UTN in proper field
Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a unique tracking number (UTN) is issued for each medical decision…
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…
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.
Prior authorization: Facet joints and cervical fusion
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn more about these changes.
Provider documentation tool for non-emergent ambulance transportation
This article is designed to assist medical providers with documenting the beneficiary’s medical condition supporting coverage for non-emergent ambulance transportation.
Prior authorization for ambulance transports is for repetitive transports
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks.…
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…
Prior authorization tips and reminders
The PA team has been receiving and processing prior authorization requests (PAR) for certain hospital OPD services. View the following reminders prior to submitting your request.
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 service that was part of a partially affirmed decision, must include the 14…
Submit prior authorization requests electronically
Are you using regular mail for submissions to First Coast? We have several electronic options that are easier and faster for you to use. Additionally, submitting documentation electronically: