20 Miss. Code. R. 2-I - SERVICES REQUIRING MANDATORY PRE-CERTIFICATION

A. All elective admissions to inpatient facilities of any type.

B. All elective surgical procedures, inpatient and outpatient. (All surgical or other invasive procedures which are administered in the context of pain management treatment shall be regulated by the specific guidelines set forth in the Pain Management section of the Fee Schedule. Only in the event a surgically invasive pain management procedure is not specifically addressed in the Pain Management guidelines shall the provisions in this section control.)

C. Pain Management Procedures. Repeat MRI scans, repeat CT Scans, repeat EMG/NCS studies, and repeat myelograms (meaning more than one such diagnostic procedure which is being prescribed for the same injury) are subject to mandatory precertificiation, except that where surgery has been performed following proper approval, the treating physician is entitled to obtain one repeat of the aforementioned diagnostic procedures post-surgery without having to obtain separate approval for each such procedure. In other words, surgical cases merit two diagnostic procedures of the kind listed herein without the necessity of pre-certification provided one procedure occurs prior to surgical treatment and one procedure occurs post-surgical treatment. The two diagnostic procedures selected by the treating provider hereunder may be the same two diagnostic procedures, or any two of the aforementioned procedures.

Notes

20 Miss. Code. R. 2-I

Amended 6/14/2017 Amended 6/15/2019