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Follow Up Procedure Guidelines - ENDOCRINOLOGY

SERIAL NUMBER Procedure 1st Qtr Per Qtr (for next 3 Qtrs) Requirements while submitting for follow-up Preauth Requirements while submitting for follow-up Claims
106 FP0106 : Hypopitutarism 3,500 1,500 Previous Discharge Summary (Clinical Evaluation, Related Pituitary Hormone Levels-Mandatory)/CT
107 FP0107 : pituitary - Acromegaly 2,000 1,500 Previous Discharge Summary (Clinical Evaluation, Related Pituitary Hormone Levels-Mandatory)
108 FP0108 : Delayed Puberty Hypogonadism (ex. Turners synd,klienfelter synd) 2,500 1,500 Previous Discharge Summary (Clinical Evaluation-Mandatory)