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Is the request for approval of postsurgical physical medicine under the postsurgical treatment guidelines subject to utilization review?

April 26, 2017Approval guidelines Medicine physical postsurgical request review Subject treatment utilization

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Is the request for approval of postsurgical physical medicine under the postsurgical treatment guidelines subject to utilization review?

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A. Yes. A request for authorization of postsurgical physical medicine is subject to utilization review pursuant to the utilization review regulations (§9792.6 et seq.) The utilization review organization is required to review the request for authorization applying its standards pursuant to the MTUS, and specifically pursuant to the postsurgical treatment guidelines.