Prior authorization requirements for hyperbaric oxygen and supervision of hyperbaric oxygen therapy

Category: Medicaid

 

Effective October 1, 2019, prior authorization (PA) requirements will change for hyperbaric oxygen and supervision of hyperbaric oxygen therapy to be covered by Anthem Blue Cross and Blue Shield Healthcare Solutions. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services guidelines, including definitions and specific contract provisions/exclusions, take precedence over these PA rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.

 

PA requirements will be added to the following:

 

• G0277 — Hyperbaric oxygen under pressure, full body chamber, per 30-minute interval
• 99183 — Physician attendance and supervision of hyperbaric oxygen therapy, per session

 

To request PA, you may use one of the following methods:

 

• Web: https://www.availity.com
• Fax: 1-800-964-3627
• Phone: 1-844-396-2330

 

Not all PA requirements are listed here. Detailed PA requirements are available to contracted providers by accessing the Precertification Lookup Tool at https://www.availity.com via

https://mediproviders.anthem.com/nv. Contracted and noncontracted providers who are unable to access the Availity Portal can call Provider Services at 1-844-396-2330.

 

ANV-NU-0065-19 August 2019