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I'm actually doing my first external appeal and it's a little new to me. My Dr did a arthroscopic hip surgery (29862, 29863, 27036, 29999 -psoas lengthening). They consider all of these "experimental". I called - even though they weren't very helpful - and the idea I got was that we needed articles from 2 of the following:
1. artciles from medical journals
2. peer-reviewd abstracts accepted for presentation at major medical associations (AAOS??)
3. Findings, studies or reserach conducted by federal research institutes.
Has anyone done an appeal like this before. I used to use articles from AAOS and Decision Health Pink Sheets to justify my appeals - but this is a little different. Any sites/organizations that I can check out would be appreciated - I only have a very limited time on this and want to make sure it's done correctly. Thanks.
1. artciles from medical journals
2. peer-reviewd abstracts accepted for presentation at major medical associations (AAOS??)
3. Findings, studies or reserach conducted by federal research institutes.
Has anyone done an appeal like this before. I used to use articles from AAOS and Decision Health Pink Sheets to justify my appeals - but this is a little different. Any sites/organizations that I can check out would be appreciated - I only have a very limited time on this and want to make sure it's done correctly. Thanks.