Prior Authorizations for CT and PET Scans: Age Requirement and Default Units (Pathways), CR 40069
April 22, 2014
Prior Authorizations (PA) entered into the MIHMS Health PAS Online Portal for Computed Tomography (CT) and Positron Emission Tomography (PET) Scans will be affected by the following changes:
The age restriction criteria, has been reconfigured for members under the age of 21 and over the age of 65 who do not require PA submission. Previously the age was rounding up to 65 when the member was 64 years old. The system has been corrected to recognize the day of the member’s 21st birthday until the day of their 65th birthday.
Previously, the system would default to two (2) units when none were entered. The system will now default to one (1) unit when a PA request is entered with no units.
If you have questions, please contact Provider Services at: 1-866-690-5585 (TTY: 711) Monday – Friday 7:00 AM EST until 6:00 PM EST.