BACK

Follow Up Procedure Guidelines - GASTROENTROLOGY

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
109 FP0109 : Gastric Varices 2,500 1,500 Previous Discharge Summary (Clinical Evaluation-Mandatory), Endoscopy, (Coagulation Profile-Mandatory)
110 FP0110 : Chronic Pancreatitis with severe pain 2,500 1,500 Previous Discharge Summary (Clinical Evaluation, Serum Pancreatic Enzymes-Mandatory)
111 FP0111 : Cirrhosis with Hepatic Encephalopathy 2,500 1,500 Previous Discharge Summary (Clinical Evaluation, LFT-Mandatory), Aptt/USG Abdomen
112 FP0112 : Cirrhosis with Hepatic renal syndrome 2,500 1,500 Previous Discharge Summary (Clinical Evaluation, LFT, RFT -Mandatory), Aptt/USG