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This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.
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 reminders related to the PAR.
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 performed to improve abnormal function, re…
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-byte unique tracking number (UTN) number…
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.
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for transitional care management (TCM) services.
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient care visits and subsequent inpatient care visits TPE round results.