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This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for paravertebral facet joint injection services.
This checklist is intended as reference to use when responding to additional documentation requests for IRF services.
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.
First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic stimulation (TMS). Read this article to learn m…
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…
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.
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.