Prior Auth Required

10436 - 19. CMS Medicare Learning Network (MLN) Matters (MM) : New “K” Code for Therapeutic

This procedure appears on the selected insurer prior authorization source.

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Procedure / Service19. CMS Medicare Learning Network (MLN) Matters (MM) : New “K” Code for Therapeutic
Procedure / Service Description

Coverage to include Real Time Continuous Glucose Monitors for Individuals with Type I - Diabetes, October 2017, https://www.health.ny.gov/health_care/medicaid/program/update/2017/oct17_mu.pdf 19. CMS Medicare Learning Network (MLN) Matters (MM)10436: New “K” Code for Therapeutic Shoe Inserts, https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network- MLN/MLNMattersArticles/Downloads/MM10436.pdf

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.