State & FederalMedicaidMay 30, 2018

Electrical stimulation device to require prior authorization

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

The electrical stimulation device will require prior authorization (PA) effective August 1, 2018.

 

Please use the Precertification Lookup Tool for authorization requirements at http://www.empireblue.com/nymedicaiddoc > Prior Authorization & Claims > Prior Authorization Lookup Tool.

 

Noncompliance with the new requirements may result in denied claims. The following code will require PA:

·         E0766 — Electrical stimulation device used for cancer treatment, includes all accessories, any type

 

Please request PA via one of the following methods:

  • Availity Portal: https://www.availity.com
  • Fax: 1-800-964-3627
  • Phone:   1-800-450-8753

 

Federal law, state law and state contract language (including definitions and specific contract provisions/exclusions) take precedence over these PA rules and must be considered first when determining coverage.

 

If you have questions about this communication or need assistance with any other item, call Provider Services at
1-800-450-8753.

PUBLICATIONS: June 2018 Empire Provider Newsletter