pre-authorization

  1. J

    Wiki Prior Authorization

    I am wondering if you are getting authorization for a procedure but you are unsure of the exact code you need do you get the higher paying code authorized and are lower paying codes covered under this authorization. For example: My physician states he is ordering a echocardiogram so we get...
  2. L

    Wiki Surgery Auths

    Curious- Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd prior to surgery that they've appealed successfully? Example: Surgery paperwork may states "Knee arthroscopy, diagnostic, meniscectomy" CPTs: 29870, 29881 called on/submitted for surgery...
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