For clinician-administered drugs, authorisation is usually tied to the J-code, the diagnosis and a dose range. Administering more than the authorised dose can leave the excess unpayable even where the claim is otherwise clean.
A payer requirement that a drug or service be approved before it is provided.
For clinician-administered drugs, authorisation is usually tied to the J-code, the diagnosis and a dose range. Administering more than the authorised dose can leave the excess unpayable even where the claim is otherwise clean.