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AmeriHealth New Jersey services that require precertification

AmeriHealth New Jersey services that require precertification Applies to services performed on an elective, non-emergency basis. Gender reassignment surgery Genetically and bio-engineered skin substitutes for wound care Inpatient services Hair transplant Acute rehabilitation admissions Injectable dermal fillers Elective surgical and nonsurgical inpatient admissions Keloid removal Inpatient hospice admissions Lipectomy, liposuction, or any other excess fat-removal procedure Long-term acute care (LTAC) facility admissions Otoplasty Skilled nursing facility admissions Rhinoplasty Cardiology Proceduresa Rhytidectomy Arterial ultrasound Scar revision Diagnostic coronary angiography Skin closures including: Percutaneous coronary intervention -Skin flaps -Skin grafts Procedures -Tissue grafts Bone graft substitutes and bone morphogenetic proteins for spine Surgery for varicose veins, including perforators and sclerotherapy surgerya Bronchial thermoplasty Any procedure, device, or service that may potentially be Cervical decompression with or without fusiona considered experimental or investigational including: Cervical disc arthroplastya New emerging technology/procedures Cochlear implant surgery Existing technolog

AmeriHealth New Jersey services that require precertification • MRI • Nuclear cardiology • PET scans All home-care services (including infusion therapy in the home)

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