Wiki Utilization Management Rule

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aaperry

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I am currently working on a project searching for the source of a utilization management rule. I am looking for the rule that 2 obstetrical ultrasounds will be paid without a prior authorization, but 3+ need prior authorization. Any help as to where to find the source of this rule is greatly appreciated. I've searched the CMS website to no avail. Thanks in advance.
 
I would review the UM policies for this service for all of your major payers individually to see what sources they list in their policies. I would also check the ACOG website to see if they have any documentation about the service and why that guidance has been published.
 
Thank you so very much for your response. I have check the major payor, and believe it or not... there's nothing listed for this particular rule, but thank you for pointing me in the ACOG website direction... I will start there. Thank you again!
 
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