Hattiesburg Posted Mon 16th of April, 2018 17:07:03 PM
We have a patient that had an MRI and failed to get her correlating x-rays the same day. She is returning to have them done within 2 weeks. Can these still be considered correlation x-rays? Is there a time frame that the correlating x-rays have to be done?
SuperCoder Answered Tue 17th of April, 2018 09:05:10 AM
A prior authorization is required for non-emergency, outpatient advanced imaging services. Prior Authorizations are valid for 45 calendar days from the date of the approval. When an authorization is entered for a procedure, payers use the day of authorization issued as the starting point for the 45-day period in which the examination must be completed. If a procedure is not completed within 45 days, a new authorization number must be obtained.
As a prior authorization number is valid for 45 days and if a patient comes back within that time for follow up and needs another imaging study, a new authorization number will be required.
Kindly check with your payer.
Hope this helps!