Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG: W0163 Pelvic Organ Prolapse Repair
Initially, the clinical guideline only applied for pelvic organ prolapse length of stay review. With this update it will also address the preoperative and post-service medical necessity review of pelvic organ prolapse repair procedures. This change is effective for dates of service on and after May 1, 2020.
This clinical guideline does not apply to Federal Employee Program® (FEP®), Medicare and Medicaid.
January 2020 Empire Provider News