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Referral vs authorization

laurmast

Guest
Messages
1
The PCP does a referral to the gastroenterologist for a "colon cancer screening" , so on the out-going referral the diagnosis is stated "colon cancer screeing." But the patient has a history of colonic polyps. Our prior-auth clerical person states "no-auth required". Should the claim to a commercial insurance, for the primary diagnosis be, history of colonic polyps, or colon cancer screeing?
 
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