Return Durable Medical Equipment Bulletin Vol. However, the form Medical Necessity Long-term Parenteral Nutrition is required to be attached to each claim submitted for payment. All Exception Process approvals will be closed effective November 30, 1999.
Prior authorization is required for the following diabetic procedure codes.
An invoice of cost showing the provider's cost for the item must be attached to the Prior Authorization Request form. Providers should contact the health plan for their program policies.