Medically Necessary Hip Revision Guidlines

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0184-Total Hip Arthroplasty: Medical Necessity and …

https://www.cms.gov/httpswwwcmsgovresearch-statistics-data-and-systemsmonitoring-programsmedicare-ffs-compliance/2a232-total-hip-arthroplasty-medical-necessity-and-documentation-requirements

For purposes of coverage under Medicare, Total Hip Arthroplasty (THA), also referred to as joint replacement, have proven to be an important medical advancement. Hip Arthroplasty surgery is most commonly performed for diseases which affect the …

Revision Total Hip Replacement - OrthoInfo - AAOS

https://orthoinfo.aaos.org/en/treatment/revision-total-hip-replacement

Revision hip replacement is a longer, more complex procedure. It requires extensive planning, as well as the use of specialized implants and tools, in order to achieve a good result. (Left) The individual …

Medical Necessity Guidelines: Inpatient Setting for …

https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/total-joint-arthroplasty

Medical Necessity Guidelines: Inpatient Setting for Elective Total Joint Arthroplasty; Hip and Knee Effective: January 1, 2023 Prior Authorization Required If …

LCD - Major Joint Replacement (Hip and Knee) (L33618)

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33618&DocID=L33618

Explanation of Revision: Based on Change Request (CR) 10901, the LCD was revised to remove all billing and coding and all language not related to reasonable …

CMM-314: Hip Surgery-Arthroscopic and Open Procedures

https://www.evicore.com/-/media/files/evicore/clinical-guidelines/solution/msk--advance/2020/evicore_cmm-314-hip-surgery_arthroscopic-and-open_eff021420_pub101519.pdf

Hip arthroscopic or open procedures may be considered medically necessary forindividuals for whom surgery is being performed for fracture, tumor, infection, orforeign …

CMM-313 Hip Replacement Arthroplasty - eviCore

https://www.evicore.com/-/media/files/evicore/clinical-guidelines/solution/msk--advance/2021/cmm-313-hip-replacement_arthroplasty_eff070121_pub030521.pdf

Total hip replacement is considered medically necessary when ANY of the following criteria have been met: An impacted fracture, or partially displaced fracture, or completely …

Hip Revision - When to Consider and What to Expect

https://iuhealth.org/find-medical-services/hip-revision

Your hip revision surgery will be done under anesthesia. You may be given general anesthesia, where you are completely asleep for the procedure or the area of the surgery …

Surgery of the Hip – Commercial Medical Policy

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/surgery-hip.pdf

Joints and Joint Procedures Coverage Rationale Surgery of the hip and surgical treatment for femoroacetabular impingement (FAI) syndrome is proven and medically necessary …

Care Guidelines for Evidence-Based Medicine

https://www.mcg.com/care-guidelines/care-guidelines/

Care guidelines from MCG provide fast access to evidence-based best practices and care-planning tools across the entire care journey, supporting clinical decision-making and documentation as well as …

Provider Medical Policies | Anthem.com

https://www.anthem.com/provider/policies/clinical-guidelines/

There are several factors that impact whether a service or procedure is covered under a member’s benefit plan. Medical policies and clinical utilization management (UM) …

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