INTERPRETIVE OR POLICY STATEMENT
Legal and Administrative Servcies [Services]
Subject: Physician-related services/healthcare professional services.
Effective Date: April 1, 2012.
Retroactive to dates of service on and after April 1, 2012, the medicaid program of the HCA has published a revised physician-related services/healthcare professional services medicaid provider guide with updates and new information as follows:
|•||Submitting authorization requests through Qualis Health for selected surgical procedures and spinal injections;|
|•||Surgical codes that require prior authorization (PA) through the HCA;|
|•||New information regarding surgeries of the uterus;|
|•||Updates to the expedited prior authorization (EPA) criteria coding list with added codes for hysterectomies;|
|•||New information regarding surgical assistant and cosurgeons;|
|•||Updated criteria for computed tomography angiography (CTA) and medical necessity;|
|•||Forms available to submit authorization requests for Prolia (Denosumab inj.); and|
|•||New information regarding electronic submission of photos and X-rays.|