The orthotic or prosthetic services are performed by a duly licensed and/or certified, if applicable, orthotic and/or prosthetic provider. (All services provided must be within the applicable scope of practice for the provider in their licensed jurisdiction where the services are provided); and The...
Before the start of therapy, the member has been informed of fertility preservation options;and For members less than 18 years of age, this medication will be prescribed by or in consultation with a provider specialized in the care of transgender youth (e.g., pediatric endocrinologist, family o...
CPT code 19350 does not describe the work that that is being done, because that code describes the actual construction of a new nipple. Code 19350 is a CCI “incidental to” edit to code 19318, and, accordingly, the services of code 19350 are included in code 19318. Similarly, graft co...
The medication must be prescribed by or in consultation with a provider specialized in the care of transgender youth (e.g., pediatric endocrinologist, family or internal medicine physician, obstetrician-gynecologist) that has collaborated care with a mental health provider for members less than 18 ye...
State of California, Department of Healthcare Services (DHS). Eyeglass lenses. Part 2 - Vision Care. Medi-Cal Provider Manual. Sacramento, CA: DHS; April 2011. Szczotka LB, Rabinowitz YS, Yang H. Influence of contact lens wear on the corneal topography of keratoconus. CLAO J. 1996;22(...
(All services provided must be within the applicable scope of practice for the provider in their licensed jurisdiction where the services are provided); and The services provided are of the complexity and nature to require being provided by a licensed or certified professional orthotist and/or ...
Third, these findings could not be generalized to the total population of COVID-19 survivors, as the study population was relatively young and had a high proportion of highly educated individuals who likely had a good healthcare provider network that referred them to outpatient rehabilitation ...
Provider supervision of repetitive walk-strengthening exercise for feeble or unstable patients is not considered medically necessary. Gait training is not considered medically necessary for relatively normal individuals with minor or transient abnormalities of gait who do not require an assistive device; ...
The orthotic or prosthetic services are performed by a duly licensed and/or certified, if applicable, orthotic and/or prosthetic provider. (All services provided must be within the applicable scope of practice for the provider in their licensed jurisdiction where the services are provided);and ...
Aetna considers implanted infusion pumps medically necessary durable medical equipment (DME) whenallof the following criteria are met: The drug is medically necessary for the treatment of the member (see medical necessity criteria for various types of infusion pumps below);and ...