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LATEST NEWS


Fidelis Care Authorization Grids Effective February 1, 2025
12/30/2024 • Posted by Provider Relations

The following sections of the Fidelis Care authorization grids have been updated effective February 1, 2025.

 

The following codes have been added to the Medicaid DME Authorization Grid:

 

E0316

Safety enclosure frame/canopy for use with hospital bed, any type

E1803

Dynamic adjustable elbow extension only device, includes soft interface material

E1804

Dynamic adjustable elbow flexion only device, includes soft interface material

E1807

Dynamic adjustable wrist extension only device, includes soft interface material

E1808

Dynamic adjustable wrist flexion only device, includes soft interface material

E1813

Dynamic adjustable knee extension only device, includes soft interface material

E1814

Dynamic adjustable knee flexion only device, includes soft interface material

E1822

Dynamic adjustable ankle extension only device, includes soft interface material

E1823

Dynamic adjustable ankle flexion only device, includes soft interface material

E1826

Dynamic adjustable finger extension only device, includes soft interface material

E1827

Dynamic adjustable finger flexion only device, includes soft interface material

E1828

Dynamic adjustable toe extension only device, includes soft interface material

E1829

Dynamic adjustable toe flexion only device, includes soft interface material

 

Visit:  Authorization Grids

 

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