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Follow Up Procedure Guidelines - surgical

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
2 FP0002 : Portocaval Anastomosis 4,000 2,000 Previous Discharge Summary (LFT, Clinical Evaluation, USG ,Doppler-Mandatory)
4 FP0004 : Splenorenal Anastomosis 4,000 2,000 Previous Discharge Summary LFT, (Doppler, CBC including peripheral smear-Mandatory)
6 FP0006 : Spleenectomy + Devascularisation + Spleno Renal Shunt 4,000 2,000 Previous Discharge Summary (LFT, Clinical Evaluation, Doppler, CBC including peripheral smear-Mandatory)
5 FP0005 : Warren Shunt (Next 3 Qtrs) 4,000 2,000 Previous Discharge Summary (LFT, Clinical Evaluation, Doppler, CBC including peripheral smear-Mandatory)
7 FP0007 : Lap - Pancreatic Necrosectomy 3,500 1,500 Previous Discharge Summary Serum Pancreatic Enzymes, Tolerance To Food, (Blood Glucose Levels, Clinical Evaluation-Mandatory)
8 FP0008 : Pancreatic Necrosectomy (open) 3,500 1,500 Previous Discharge Summary Serum Pancreatic Enzymes, Tolerance To Food, (Blood Glucose Levels, Clinical Evaluation-Mandatory)