CBI coding hloov tshiab, tus kws kho mob cov txiaj ntsig kev hloov pauv + poj niam txiv neej lees paub cov kev pabcuam nug
Koj puas muab kev pabcuam kev lees paub poj niam txiv neej?
Thov qhia rau peb seb koj puas muab kev pabcuam kev lees paub poj niam txiv neej los ntawm sau daim foos no!
Peb yuav tau hloov kho Alliance cov chaw muab kev pab cov npe kom suav nrog cov chaw muab kev pabcuam hauv network muab cov kev pabcuam no, ua raws li PAB 24-018. Cov ntaub ntawv no tseem yuav pab peb cov tswv cuab uas tab tom nrhiav kev saib xyuas poj niam txiv neej nrhiav tau cov kws kho mob zoo.
Thov saib rau yav tom ntej Alliance cov cai thiab cov txheej txheem nyob rau hauv Alliance Provider Manual (yog tias tsim nyog) hais txog APL no. Xav paub ntau ntxiv ntawm peb lub vev xaib.
Kev Ntsuam Xyuas Kev Nyuaj Siab rau Cov Tub Ntxhais Hluas thiab Cov Neeg Laus hloov tshiab
Muaj kev hloov kho coding rau Care-Based Incentive (CBI) ntsuas Kev Ntsuas Kev Nyuaj Siab rau Cov Hluas thiab Cov Neeg Laus, siv tau rov qab pib txij Lub Ib Hlis 1, 2025.
LOINC code rau Edinburgh Postnatal Depression Scale (EPDS) kev tshuaj ntsuam tam sim no yog 99046-5.
Ib qho kev xa tawm yav dhau los LOINC cov lej rau kev tshuaj ntsuam EPDS yuav tsum tau xa rov qab los ntawm Cov Ntaub Ntawv Xa Khoom (DST). Yog tias koj muaj lus nug, thov email [email protected].
Tus kws kho mob muab tshuaj hloov pauv kom paub, pib lub Rau Hli 1, 2025
Lub Alliance tau hloov pauv rau tus kws kho mob tau txais txiaj ntsig tshuaj. Koj tuaj yeem nrhiav kev tso cai ua ntej (PA) cov txheej txheem ntawm peb lub vev xaib.
Cov kev hloov pauv yog raws li nram no:
| HCPCS Code | Tshuaj | Hloov | Nyiam Tshuaj |
| qw 5147 | Pavblu (aflibercept-ayyh) | PA tshiab | Avastin (Bevacizumab) |
| qw 5149 | Enzeevu (aflibercept-abzv) | PA tshiab | Avastin (Bevacizumab) |
| qw 5150 | Ahzantive (aflibercept-mrbb) | PA tshiab | Avastin (Bevacizumab) |
| qw 5124 | Byooviz (ranibizumab-nuna) | Hloov kho PA Cov Cai | Avastin (Bevacizumab) |
| j2267 ua | Omvoh (mirkizumab-mrkz) | Hloov kho PA Cov Cai | Remicade (infliximab) |
| j2327 ua | Skyrizi (risankizumab-rzaa) | Hloov kho PA Cov Cai | Remicade (infliximab) |
| j3301 ua | Triamcinolone acetonide (Kenalog-10, Kenalog-40) | Tshiab PA Cov Cai- rau cov plaub hau poob yuav tsum tau kuaj xyuas ntawm alopecia areata |
Lub Alliance tau hloov kho cov cai hauv qab no hauv khw muag tshuaj. Yog xav thov ib daim qauv, thov hu rau Alliance Pharmacy Department ntawm 831-430-5507.
- 403-1103: Pharmacy Authorization Request Process Review
- 403-1104: Lub Hom Phiaj, Kev Tsim Kho thiab Kev Ua Haujlwm ntawm Pawg Kws Tshuaj thiab Kho Mob
- 403-1109: Tsis yog-FDA pom zoo tshuaj thiab tshuaj ntsuab
- 403-1112: Therapeutic Equivalence of Generic Drugs
- 403-1141: Tus kws kho mob/cov chaw tswj xyuas cov tshuaj uas xav tau kev tso cai ua ntej
- 403-1142: Biosimilars, ib
- 403-1146: Txoj Cai Them Rov Los Siv Tshuaj Txhaum Cai
- 403-1151: Txoj Cai Hauv Tsev Infusion
- 403-1154: Naloxone Distribution Program
