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Does a surgeon need to obtain pre-authorization for repeat surgeries to any body part or only for those body parts covered by the Medical Treatment Guidelines?

April 26, 2017body Covered medical obtain pre-authorization repeat surgeon surgeries treatment

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Does a surgeon need to obtain pre-authorization for repeat surgeries to any body part or only for those body parts covered by the Medical Treatment Guidelines?

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The prior authorization for repeat surgeries applies to any surgery covered by the 4 Medical Treatment Guidelines (mid and low back, neck, shoulder, knee). For surgery to body parts not covered by the Medical Treatment Guidelines and costing more than $1000, pre-authorization is required.