The 0373T code with UB modifier for higher intensity intervention services has been added to the ITP form and effective as of Thursday 10/14/2021. This code and modifier are now available when creating Cases in the Kepro Atrezzo Portal.
Please join KEPRO and attend our How to Submit An Outpatient Request training on October 21, 2021, @ 9am CST. Access the following link to join the webinar session: Webinar Series Link
A temporary peacetime emergency waiver allowing the recipient's verbal or electronic written approval of the ITP or change in the ITP for mental health services or assessments delivered through telehealth remains in effect beginning Sept. 1 2021, based on new legislation. You may document the recipient's verbal approval or electronic written approval of the treatment plan or change in the treatment plan instead of obtaining the recipient's signature.
This is effective Sept. 1, 2021 for providers of the following services:
Call the Minnesota Health Care Programs Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions about this message.
UM Reviews and Clinical Documentation
Please be advised, effective Monday, August 2nd 2021, a new case will need to be created for recertification requests. Additionally, as a reminder, please complete the questionnaire.
For case submission - the only procedure code that can be submitted is 97151 with Modifier U8.
NOTE: You must attach the Comprehensive Multi-Disciplinary Evaluation (CMDE) Form with the Signature Page. This Form is available in the drop down selection when you are attaching your document(s).
The only procedure codes that can be submitted are: 97153, 97154, 97155, 97156, 97157, H0032, AND H0046 with modifier UB.
NOTE: You must attach the Individual Treatment Plan (ITP) Form with the Signature Page. This Form selection is available in the drop down when you are attaching your document(s).
Under Covered Services, we provided two examples of when both a portable and stationary ventilator may be covered.
Under Noncovered Services, we added a reminder that manual resuscitation bags are covered.
Under Authorization, we explained authorization requests for a second ventilator must include a letter of medical necessity and we added the criteria that must be addressed and documentation required in the letter of medical necessity.
Effective 08/10/2021 - The number of additional prophies approved for the current calendar year will be calculated based on the date of the first Prophy and MRC submitted on the questionnaire. The approved dates will be backdated to January 1st of the current year to allow for the authorization to be used for retrospective D1110 for the CURRENT calendar year.
1st Prophy date 08/02/2021, 3 MRC, 2 calendar year(s).
1 additional D1110 approved for the period 01/01/2021 to 12/31/2021. 3 additional D1110 approved for the period 01/01/2022 to 12/31/2022.
Reminder: Submit D1110 requests independent of other Dental Requests. D1110 requests submitted for auto-approval will receive authorization within 2 business days and for up to 2 calendar years.
PLEASE NOTE: Retrospective requests for the PRIOR calendar year must be submitted on a separate case.
Kepro is very excited to offer this training to assist you with submitting and obtaining approvals within 2 business days for qualified PROPHYLAXIS D1110 Prior Authorization Requests - for up to two calendar years!
Note: All Retrospective Requests will be routed for manual review. The benefit to Providers include:
Kepro Questionnaire to help reduce “pends” for additional clinical Information. Please share this invitation with the appropriate staff in your organization who submits prior authorization D1110 prophylaxis requests and who will be available for the training session.
You must be registered for Kepro’s Atrezzo Portal in order to participate in the WebEx and to submit requests via the portal. If you cannot access the Web-Ex presentation online, you may join the audio portion of the presentation by calling the number and entering the code above. Instructions for Atrezzo Provider Portal registration are below. Are you registered for Kepro's Atrezzo Provider Portal? If you have not registered for online submission, please do so prior to the training. Visit MHCP.kepro.com, click the Atrezzo Login button and you will be prompted to enter your NPI number and Registration Code. To obtain your Registration code contact Kepro Customer Service at 866.433.3658 for assistance.
*The Atrezzo Provider Portal is a secure web based system for the submittal of Prior Authorization requests and uploading of ALL supportive documentation to substantiate Medical Necessity.
Effective 10/1/2020 EIDBI requested dates of services cannot exceed 180 days duration
There are no announcements at this time.
Kepro is URAC accredited in Health Utilization Management and Case Management. We are also licensed to perform medical reviews in 29 states.