Billing Beat

Prior Authorization Requirements

August 30, 2017

The following laboratory procedure codes that are being added to the MA Program Fee Schedule will require prior authorization: New Genomic Sequencing Codes 81413 and 81414 plus Multianalyte Assays with Algorithmic Analyses (MAAA) code  81512. These updates are described in the MA Provider Handbook which may be viewed online at: https://www.dhs.pa.gov/publications/forproviders/promiseproviderhandbooksandbillingguides/index.htm.

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