Prior Approval Items- DME/Supplies
Prior Approval Items- DME/SuppliesThe Prior Approval Items tab for DME and Supplies requests allows you to input service lines identifying the services that are being requested for the patient. The main body of the tab contains an arrangement of fields with each row representing a requested service line. The following fields are displayed:
Line: The line number of the request. You may not change this field. Note that the request line numbers and the subsequent claim line numbers do not have to match.
Service Date: The estimated or proposed date that the requested service is to be performed. Must be greater than or equal to the current date.
Item/Proc & Modifier: The HCPCS procedure code and the procedure code modifier.
Req'd Quantity: The requested units of services.
Req'd Times: The requested number of times.
Req'd Amount: The requested dollar amount of services.
More Details: This field navigates you to the More Details view of the line. Note that the More Details section is only relevant for Home Oxygen Therapy service lines. However, Attachments may be added for other service lines.
Remove: This field removes the line from the request.
The More Details view of a line provides a mechanism for you to add more detailed information about a requested line. The component displays the following fields:
Line, Service Date, Item/Proc & Modifier, Req'd quantity, Req'd Times, and Req'd Amount: TThese fields display the information that was entered on the previous page. The data may not be modified from this tab.
Oxygen Equipment Type: These fields allow you to identify the requested equipment type. You must populate at least one of these fields using the adjacent pop-up.
Equipment Reason: Allows you to enter optional free form text that justifies the use of the equipment.
Oxygen Delivery System: This required field can only be populated by the associated pop-up and identifies the method of oxygen delivery.
Oxygen Flow Rate: This required field specifies a patient's oxygen flow rate in liters per hour.
Portable Oxygen System Flow Rate: This optional field specifies a device's oxygen flow rate in liters per hour.
Test Type and Results: These required fields include a radio button set that establishes the test type and a text field used to record the test results.
Test Condition: These fields allow you to identify the condition in which the test was administered. At least one of these fields must be populated using the associated pop-up.
Test Findings: These fields allow you to identify the test findings. At least one of these fields must be populated using the associated pop-up.
Daily Oxygen Use Count: The number of times per day a patient must use oxygen.
Oxygen Use Period Hour Count: The number of hours in a period of oxygen use.
Respiratory Therapist Order: Optional free form text describing treatment to be provided by the respiratory therapist.
This group allows you to apply attachments to a line. The Enter More Attachments link allows for the entry of 5 additional attachment fields.
Copy Attachments from Line: Allows you to apply attachments used in another line to the current line.
Type: This field may be populated by using the associated pop-up and identifies the type of attachment
Transmission Code: This field may be populated by using the associated pop-up and identifies the method by which the attachment will be transmitted to eMedNY
Control Number: This field identifies the attachment's control number in your records. It is an internal number that is for the provider's office use only and does not correspond to the subsequent PA number issued by NYS Medicaid.
Description: This field describes the attachment.
The Comments field allows you to enter free form text that clarifies the request. You may copy comments into the current line from another line in the current PA.
After you have completed the additional items for the current line, choose Close to save the information and return to the previous page. If you wish to abandon the additional items for the current line, choose Clear and you will return to the previous page.