Upper GI Endoscopy Authorization Form Tufts Health Plan Tufts Healthplan
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People also ask
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What is the phone number for Tufts prior authorization?
The number to call to obtain a prior authorization is 1-866-642-9703. -
What is the billing code for upper endoscopy?
Article - Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization (A56389) -
Does Tufts Medicare Preferred require prior authorization for MRI?
Depending on the member's plan, providers must contact either National Imaging Associates' (NIA) or Cigna for high-tech imaging prior authorizations, for the following services: CT/CTA scans. MRI/MRAs. PET scans. -
What is the CPT code for EGD only to the stomach?
CPT® 43235, Under Esophagogastroduodenoscopy Procedures. -
What is the CPT code 43249?
CPT® Code 43249 - Esophagogastroduodenoscopy Procedures - Codify by AAPC. -
What is the CPT code 43235?
Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) -
What is the fax number for Tufts Health Plan prior authorization?
Prior authorization requests should be faxed to the Precertification Operations Department at 888-415-9055 (Tufts Health Together, Tufts Health Direct), 857-304-6304 (Tufts Health Unify) or 857-304-6404 (Tufts Health RITogether). -
What is the ICD 10 code for upper GI endoscopy?
Inspection of Upper Intestinal Tract, Via Natural or Artificial Opening Endoscopic. ICD-10-PCS 0DJ08ZZ is a specific/billable code that can be used to indicate a procedure. -
What is the difference between 43237 and 43259?
43237 vs 43259 Basically, 43237 is when the EUS view 1 or 2 structures (either the esophagus, stomach, or duodenum) and 43259 is if all 3 structures are examined with the EUS. -
Is a referral prior authorization?
A referral is issued by a primary care physician (PCP) for the patient to see a specialist. In contrast, prior authorization is issued by the payer (an insurance provider), giving a medical practice or physician the approval to perform a medical service. -
Does Tufts Medicare Preferred require prior authorization?
Prior authorization is required for certain procedures, drugs, items, and/or supplies that require medical necessity or utilization review either through Tufts Health Plan or select approved vendors. Services that require prior authorization may also require a referral to the rendering specialist.
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