Prior Authorization - JF Part A
Medical Review
- Documentation Requests: How, Who and When to Send
- Documentation Requirements
- How Do I Check DDE for an ADR?
- How Do I Respond to an ADR?
- MR FAQs
- MR Overview
- MR Reopening
- Medical Documentation Signature Requirements
- Medical Record Review Results
- Order Authentication Requirements
- Prior Authorization
- Post-Pay Reviews
- Pre-payment Review
- Targeted Probe and Educate (TPE)
- Who Reviewed My Claim
- Why Is My Claim Denied
- Other Review Contractors
Tell us what you think
Your comments will help us improve our services.
Take the Prior Authorization Survey
Attend a
Webinar
Webinar
- Updates for Hospital Outpatient Department (OPD) Services Prior Authorization (PA) Program - PA for Certain Hospital OPD Services 05/23/23
, PA for Certain Hospital OPD Services 06/14/23
, PA for Certain Hospital OPD Services 06/21/23
, PA for Certain Hospital OPD Services 07/12/23
, PA for Certain Hospital OPD Services 07/19/23
, PA for Certain Hospital OPD Services 08/08/23
Days Until Implementation of Outpatient Prior Authorization Requests for Facet Joint Interventions:
Prior Authorization
Prior Authorization for Certain Hospital Outpatient Department (OPD) Services - View outpatient department services that require prior authorization, the authorization process, how to submit a prior authorization request, the documentation requirements and coverage for the 7 services: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, vein ablation, spinal cord neurostimulator, and cervical fusion
Last Updated Thu, 21 Jul 2022 12:25:09 +0000
Prior Authorization Lookup Tool
Determine which HCPCS codes require a Prior Authorization
Loading
Enter HCPCS Code: