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Resubmission of Certain Enteral Nutrition Claims Due to Change in Prior Authorization Requirements

As announced in ForwardHealth Update 2023-23, titled “New Coverage Policy for Enteral Nutrition Formula and Products,” as of June 9, 2023, certain enteral nutrition products no longer require prior authorization (PA). Some enteral nutrition claims submitted to ForwardHealth after June 9, 2023, may have been incorrectly denied due to this change in requirements.

Beginning September 18, 2023, providers can resubmit enteral nutrition claims with dates of service on and after June 9, 2023, that may have been incorrectly denied for procedures that no longer require PA.

Refer to the Enteral Nutrition Formula Procedure Codes topic (#1734) in the ForwardHealth Online Handbook for updated PA requirement information for these codes.

 
 
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