Get the free Provider Tool Based on Anthem Corporate Medical Policy SURG.00023
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This document serves as a provider tool for requesting mastectomy for gynecomastia, detailing eligibility requirements, necessary information, and considerations for medical policy.
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How to fill out provider tool based on
How to fill out Provider Tool Based on Anthem Corporate Medical Policy SURG.00023
01
Access the Provider Tool through the Anthem website or your provider portal.
02
Select the relevant medical policy, SURG.00023.
03
Gather necessary patient information including demographics, diagnosis, and treatment history.
04
Review the specific requirements listed in the medical policy for the service in question.
05
Complete each section of the tool according to the instructions and enter the required data.
06
Attach any necessary documentation that supports the medical necessity of the service.
07
Submit the completed tool for review and follow up as necessary.
Who needs Provider Tool Based on Anthem Corporate Medical Policy SURG.00023?
01
Healthcare providers seeking authorization for procedures governed by Anthem Corporate Medical Policy SURG.00023.
02
Practitioners involved in evaluating or providing surgical services as outlined in the policy.
03
Facilities and organizations that require compliance with Anthem's billing and documentation standards.
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People Also Ask about
What is the difference between CPT 19316 and 19318?
19316 (Mastopexy) 19318 ( reduction) 19325 ( augmentation with implant)
What is the code for lift?
CPT® 19316, Under Repair and/or Reconstruction Procedures on the .
What is the CPT code for lift procedure?
Tamara Wagner: The LIFT procedure (ligation of intersphincteric fistula) would be assigned CPT code 46275, “Surgical treatment of fistula (fistulectomy/fistulotomy); intersphincteric.”
What is the CPT code for lift?
CPT® 19316, Under Repair and/or Reconstruction Procedures on the .
What is a medical necessity for reduction?
Medically necessary reduction is a life-transforming procedure that addresses both the physical and emotional challenges caused by overly large . This surgery can significantly enhance your quality of life by reducing pain, improving mobility, and restoring your self-confidence.
What is reconstruction with insertion of tissue expander?
What is a reconstruction with an implant or tissue expander? A reconstruction is an operation to recreate a shape after you have had a mastectomy (removing all of your ). Your surgeon will use a implant or tissue expander (expandable implant) to recreate the shape of a .
What is the difference between CPT code 11970 and 19342?
Code 19342 is used when the tissue expander exchange requires additional work over and above the minor adjustments to the capsule included in CPT code 11970. Using code 19342 will account for the additional work performed by the surgeon. A separate code is not assigned for capsulectomy or capsulotomy.
Does insurance cover reconstruction after lumpectomy?
reconstruction and health insurance This can include procedures that may be needed over time to refine the reconstructed (s). Reconstruction procedures are covered by insurance regardless of whether they are done at the same time as a mastectomy or lumpectomy or take place months or years later.
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What is Provider Tool Based on Anthem Corporate Medical Policy SURG.00023?
The Provider Tool based on Anthem Corporate Medical Policy SURG.00023 is a standardized instrument used to assess and facilitate the review process for surgical procedures in accordance with Anthem's medical policies.
Who is required to file Provider Tool Based on Anthem Corporate Medical Policy SURG.00023?
Providers who are seeking authorization for surgical procedures that fall under Anthem Corporate Medical Policy SURG.00023 are required to file the Provider Tool.
How to fill out Provider Tool Based on Anthem Corporate Medical Policy SURG.00023?
To fill out the Provider Tool, providers should follow the guidelines outlined in the instructions provided, ensuring they complete all relevant sections with accurate and detailed information relating to the patient and procedure.
What is the purpose of Provider Tool Based on Anthem Corporate Medical Policy SURG.00023?
The purpose of the Provider Tool is to streamline the submission process for surgical procedures, ensuring all necessary information is provided for an efficient evaluation and approval by Anthem.
What information must be reported on Provider Tool Based on Anthem Corporate Medical Policy SURG.00023?
The information that must be reported includes patient demographics, clinical history, details of the requested surgical procedure, supporting medical necessity, and any prior treatments or evaluations that pertain to the surgery.
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