Prior Auth Required

20131 - https://www.govinfo.gov/content/pkg/FR-2006-11-27/html/E6- .htm

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Servicehttps://www.govinfo.gov/content/pkg/FR-2006-11-27/html/E6- .htm
Procedure / Service Description

SOURCES - 4. Federal Registry, Vol 71. No 227, Medicare Program: Notification of Hospital Discharge Appeal Rights; Final Rule, https://www.govinfo.gov/content/pkg/FR-2006-11-27/html/E6-20131.htm 5. National Committee on Quality Assurance (NCQA) Standards and Guidelines. 6. Guiding Principles for the Review and Approval of Clinical Review Criteria for Mental Health

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.