Medical review

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ASC HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Skin substitute HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Blepharoplasty, eyelid surgery, brow lift, and related services

Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly for cosmetic reasons. Functional or reconstructive eyelid surgery is…

Prior authorization program initiatives

Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing…

Radiopharmaceutical HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Skin substitute HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

ASC HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Botulinum toxin injections

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.