Does M0100 require prior authorization?

No, M0100 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for M0100?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

No documentation requirements are specified in this Clinical Policy Bulletin.
No specific documentation requirements or required medical records/test results are specified in this CPB. (The policy primarily identifies tests/procedures considered obsolete/not covered and lists associated CPT/HCPCS/ICD-10 codes.)

Implicit from policy: gastric freezing (intragastric hypothermia) is NOT covered — see Experimental and Investigational section: "Aetna considers gastric freezing (intragastric hypothermia) experimental and investigational for chronic peptic ulcer disease or any other indications because there is insufficient evidence to support its effectiveness for these indications."
None. Aetna considers gastric freezing (intragastric hypothermia) experimental and investigational for chronic peptic ulcer disease or any other indications because there is insufficient evidence to support its effectiveness for these indications.
None specified. This Clinical Policy Bulletin addresses obsolete and unreliable tests and procedures and lists tests/procedures that Aetna considers experimental and investigational (i.e., not covered).

AETNA-CPB-0527, Intragastric Hypothermia

AETNA-CPB-0438, Obsolete and Unreliable Tests and Procedures

Ask Backwork about documentation requirements, denial risks, or coverage in your state.