Results 1 to 3 of 3

Prior Authorization Question

  1. #1
    Default Prior Authorization Question
    Clearnace Sale
    Can anyone tell me if there are written rules stating you only need to prior authorize the primary procedure code when doing multiple procedures? I understand you lead with the highest RVU valued code however, is it true or untrue you only need to list your primary procedure when submitting a prior authorization? Any expertise, resources, references, etc would be much appreciated.

  2. #2
    Milwaukee WI
    Default We list ALL the planned procedures
    We list ALL the planned procedures in our Prior Auth request.

    We have had situations where due to circumstances discovered intraoperatively an additional procedure has been performed and denied as not authorized.

    Just had a denial yesterday ... but I have a written response from insurance with authorization number that lists BOTH procedure codes.

    Better safe than sorry.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Seattle First Hill
    I agree with the above post. We pre-authorize all codes that are going to be done as well.

    ~Kirsten, CPC

Similar Threads

  1. Prior Authorization Administrative Fee - HELP!
    By mrsjehu in forum General Discussion
    Replies: 7
    Last Post: 06-10-2015, 01:45 PM
  2. Prior Authorization for CABG
    By efrohna in forum Cardiovascular Thoracic
    Replies: 0
    Last Post: 02-25-2014, 11:51 AM
  3. Appealing No Precert/No prior authorization
    By lizzardb in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 06-22-2012, 11:24 AM
  4. Prior authorization for Radiology ordered from ER
    By Sueedwards in forum Emergency Department
    Replies: 0
    Last Post: 06-17-2011, 06:10 AM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.