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 PRIOR AUTHORIZATION DRUG ATTACHMENT PADGA, F 11049, Dhs Wisconsin 2013

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specifying the drug details here we list oxycodone 5325 M with acetaminophen and provide the exact dosage one tablet every 4 to 6 hours as needed this dosage gives the patient flexible pain relief without overprescribing showing Medicare that the prescription is tailored answering medicare's clinical questions these questions help Medicare confirm that the patient's pain history justifies the need for a controlled substance we start by entering the primary diagnosis code which is cd10 code g89.4 for chronic pain syndrome this diagnosis code supports the request by highlighting the patient ongoing struggle with chronic pain we also provide a detailed history of previous pain management treatments Medicare expects documentation that shows the patient tried non-opioid options like Gabapentin or acetaminophen alone without finding relief this information builds the case for using a stronger option like oxycodone

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