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Credentialing Alliance ORGANIZATIONAL DATA FORM
a. Policy shall be endorsed, as required by this written agreement, to include the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with
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CODE DESCRIPTION CPT/HCPCS *Please note: This list applies ...
www.mccofaz.comcpt/hcpcs code all inpatient services require an authorization code description auth required 0095t rmvl artific disc addl crvcl yes 0098t rev artific disc addl yes 0213t injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal joint) yes 0214t injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal joint) yes
Magellan Complete Care (MCC) of Arizona NCPDP Version D.0 ...
www.mccofaz.comPage 4 | MCC of AZ Payer Specifications Patient Segment Segment Identification (111-AM) = “Ø1” Claim Billing/Claim Re-bill Field NCPDP Field Name Value Payer Usage Payer Situation
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