Is anyone else seeing authorization denials for not meeting medical necessity for 77387 (Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed).
When submitting authorization for approval for radiation treatment planning and delivery (77263,77280,77417,77290,77333,77334,77295,77412,77427,77336) all services are being approved but 77387 is being denied as not meeting medical necessity. All cases are for breast cancer and receiving the denials from Allegiance and Evicore but when we try to follow up there is never a valid reason for not meeting medical necessity. Any guidance would be appreciated. Thank you!
When submitting authorization for approval for radiation treatment planning and delivery (77263,77280,77417,77290,77333,77334,77295,77412,77427,77336) all services are being approved but 77387 is being denied as not meeting medical necessity. All cases are for breast cancer and receiving the denials from Allegiance and Evicore but when we try to follow up there is never a valid reason for not meeting medical necessity. Any guidance would be appreciated. Thank you!