Non-Michigan Provider Precertification Pre-authorization ...
Non-Michigan Provider Precertification Pre-authorization Requirements Contents if BCBSM will cover the cost of a proposed service. BCBSM requires pre- A review of a patient’s symptoms and proposed treatment to determine, ... Get Document
Blue Cross Blue Shield Of Michigan Medical Policy
Blue Cross Blue Shield of Michigan Medical Policy treatment, the provider does not require face to face contact to make an optimal decision. It insurers to cover telemedicine in provided services comparable to that of in person, has ... View Doc
Sample Letter Of Medical Necessity - MedBen
Sample Letter of Medical Necessity Must be on the physician/providers letterhead treatment described, as “quitting smoking, healthier diet and regular or daily exercise recommended” does not provide enough information. Your provider must specifically name and describe the recommended ... Read Document
Cosmetic And Reconstructive Surgery Procedures
2. Treatment needed for the non-cosmetic repair of an accidental injury Varicose Vein treatments Selected Skin conditions C. In general, coverage is not provided for the following conditions and/or Cosmetic and Reconstructive Surgery Procedures . ... Retrieve Full Source
Obstructive Sleep Apnea Treatment Services - Cigna
Treatment is considered medically necessary when ALL of the following criteria are met: • individual meets the criteria for PAP (detailed in PAP section above) • individual does not have a comorbid condition that would be expected to degrade the accuracy of auto- ... Content Retrieval
Local Coverage Determination Coding Guidelines
Local Coverage Determination Coding Guidelines Contractor Name Wisconsin Physicians Service (WPS) Contractor Number necessary to furnish a dialysis treatment. 2 For dialysis to take place there must be a means of access so that the exchange of waste ... View This Document
SAMPLE - UnitedHealthcare
SAMPLE COC.ACA15.CER.I.11.ME.SB [2] Be Aware this Benefit Plan Does Not Pay for All Health Services providers must make those treatment decisions. We have the discretion to do the following: Interpret Benefits and the other terms, ... Get Content Here
Clinical Policy: Lymphedema And Venous Stasis Ulcer Treatments
Clinical Policy: Lymphedema and Venous Stasis Ulcer Treatments usually located low on the medial ankle over a perforating vein, or along the line of the long or If precipitated by trauma, they can occur higher on the leg. The goal of treatment, which can be achieved with leg elevation ... Access Doc
REFERRAL/AUTHORIZATION GUIDELINES Commercial Plans
Moda Health Referral/Authorization Guidelines Oregon– updated September 2014 Page 1 of 7 IF YOUR PLAN IS Dentist/Oral Surgeons for treatment of dental accidents, TMJ as defined by the member’s plan, and/or oral Varicose vein surgery/sclerotherapy DENTAL SERVICES ... Access This Document
CMS Payment Policies - Intersocietal
IAC Vascular Testing (formerly ICAVL) – CMS Payment Policies (Last Reviewed by the IAC on 6/26/2018) 1 PLEASE NOTE: These policies are changed and updated regularly by the insurance carriers and list requirements as relatedto IAC accreditation only. ... View Doc
Prior Authorization Requirements - Health Net
Health Net Access, Inc. Treatment of varicose veins Surgical procedure Uvulopalatopharyngoplasty (UPPP) and laser-assisted UPPP Surgical procedure X-Stop Surgical procedure *Dual eligible members are members who are eligible and enrolled for coverage through Medicare and Medicaid. Dual ... Fetch Content
PRECERTIFICATION & PRIOR AUTHORIZATION
• MH/SA Residential Treatment Centers • Obesity Surgery • Major Skin procedures • Face/jaw surgery (except trauma) • Transplants • Breast reduction • Back/spine (except trauma, malignancy). Varicose vein surgery . ... View This Document
Medical Policy (SURGICAL STOCKINGS AND COMPRESSION GARMENTS)
C. Varicose veins; D. Phlebitis/Thrombophlebitis; E. Deep vein thrombosis (DVT) prophylaxis during pregnancy and postpartum, or immobilization due to surgery, SUBJECT: SURGICAL STOCKINGS AND COMPRESSION GARMENTS POLICY NUMBER: 1.01.14 ... Document Viewer
GA STANDARD PREAPPROVAL REQUIREMENTS
GA STANDARD PREAPPROVAL REQUIREMENTS BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome Pain Management:Cervical, Thoracic, Lumbar Facet Injections (Fully Insured to AIM MSK – date to be determined ... Read Here
Corporate Medical Policy - Blue Cross NC
Page 2 of 15 An Independent Licensee of the Blue Cross and Blue Shield Association Varicose Veins, Treatment for 3. Removal of the superficial vein from circulation, for example by stripping of the great and/or ... View Full Source
2017 Endovascular Reimbursement Coding Fact Sheet
2017 Endovascular Reimbursement Coding Fact Sheet 4 of 11 Procedure Codes and Physician Reimbursement for Endovascular Procedures CPT® Code carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, and ... Fetch Content
Comments And Responses Regarding Draft Local Coverage ...
Comments and Responses Regarding Draft Local Coverage Determination vein thrombosis in patients who are candidates for anticoagulation or invasive therapeutic procedures. “primary varicose veins.” ... View Document
Prior Authorization Requirements For Iowa Effective Mar. 1, 2016
This list represents United Healthcare Community Plan inpatient and outpatient prior authorization requirements for Iowa Treatment of maxillofacial (jaw) functional impairment varicose veins of the extremities 36468 36475 36478 37700 ... Document Viewer
BlueCross BlueShield Of Tennessee, Inc. (BCBST)
BlueCross BlueShield of Tennessee, Inc. (BCBST) (Applies to all lines of business unless stated otherwise) Varicose Vein Treatment of Lower Extremities Note: Cover Tennessee plans. Physician's Guide to Patient ... Document Viewer
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