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CG-MED-23 Home Health

WebG0153. Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes. G0155. Services of clinical social worker in home …

Actived: 3 days ago

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Full list of Medical Policies and Clinical Guidelines

WebMedical Policy. Administrative. ADMIN.00006 Review of Services for Benefit Determinations in the Absence of a Company Applicable Medical Policy or Clinical …

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Medical Policies and Clinical UM Guidelines

WebThe MCG guidelines we are licensed to use include ( (1) Inpatient & Surgical Care (ISC), (2) General Recovery Care (GRG), (3) Recovery Facility Care (RFC), (4) Chronic Care (CC) …

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CG-MED-19 Custodial Care

WebSubject: Custodial Care. Guideline #: CG-MED-19. Publish Date: 01/03/2024. Status: Revised. Last Review Date: 11/09/2023. Description. This document defines …

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CG-SURG-83 Bariatric Surgery and Other Treatments for

WebAccording to the National Institutes of Health (NIH), an increase of 20 percent or more above an individual’s ideal body weight is the point at which excess …

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CG-MED-71 Chronic Wound Care in the Home or Outpatient Setting

WebMedically Necessary: Note: To be eligible for wound care in the home setting, the individual must be confined to the home as defined in CG-MED-23 Home Health. …

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CG-BEH-14 Intensive In-home Behavioral Health Services

WebMedically Necessary:. Intensive in-home behavioral health services may be considered medically necessary when ALL of the following selection criteria are met (A, …

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CG-REHAB-08 Private Duty Nursing in the Home Setting

WebDescription. This document defines private duty nursing (PDN) in the home and the conditions under which it would be considered medically necessary. PDN refers …

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CG-REHAB-12 Rehabilitative and Habilitative Services in

WebServices performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes. G0159. Services performed by a …

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CG-LAB-11 Screening for Vitamin D Deficiency in Average

WebDescription. This document addresses routine testing of serum vitamin D levels in adults and children, in the absence of clinical signs and symptoms of vitamin D …

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CUSTOMIZATION TO CARE GUIDELINES 25th EDITION

WebFebruary 11, 2021. This document provides a high level summary of customizations and modifications to MCG Care Guidelines, collectively, “customized guidelines.”1234 The …

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Clinical UM Guideline

WebThe groups were then categorized by severity of the Cranial Vault Asymmetry Index (CVAI). The categorization of mild (CVAI 3-7 %), moderate (CVAI 7-12%), and severe (CVAI …

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CG-MED-26 Neonatal Levels of Care

WebIn 2012 (reaffirmed 2015), the AAP issued a policy statement outlining the designations of levels of neonatal care to distinguish and standardize newborn care …

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Provider update COVID-19 Update: Amerigroup suspends …

WebPage 2 of 3 The 21-day inpatient requirement before transferring a patient to a long-term acute care hospital is suspended. Concurrent review for discharge planning will continue …

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rovider esletter

Webhealth providers have a new discharge call-in line. If a member is discharging from inpatient or residential treatment, providers may send the discharge information via the call-in line …

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ADMIN.00002 Preventive Health Guidelines

WebMedical Policy. Subject: Preventive Health Guidelines. Document #: ADMIN.00002. Publish Date: 06/28/2023. Status: Reviewed. Last Review Date: …

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Provider update COVID-19 information from Amerigroup …

Webimpact our customers and our health care provider partners. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and …

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Participating Provider Quick Reference Card

WebMental health Prior authorization is not required for network providers requesting most outpatient behavioral health (BH) services. Call Provider Services at 800-454-3730 and …

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CG-DME-23 Lifting Devices for Use in the Home

WebGuideline #: CG-DME-23. Publish Date: 09/27/2023. Status: Reviewed. Last Review Date: 08/10/2023. Description. This document addresses lifting devices for use …

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CG-BEH-02 Adaptive Behavioral Treatment

WebCenter for Health Services and Policy Research, British Columbia Office of Health Technology Assessment, Autism and Lovaas treatment: A systematic review of …

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CG-LAB-09 Drug Testing or Screening in the Context of

WebCordant CORE ™; Cordant Health Solutions. 0082U. Drug test(s), definitive, 90 or more drugs or substances, definitive chromatography with mass spectrometry, and …

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CG-DME-07 Augmentative and Alternative Communication (AAC …

WebMedically Necessary: Augmentative and alternative communication devices with digitized or synthesized speech output are considered medically necessary when all …

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