PRIOR: CARELON
Key steps for requesting diagnostic codes through Carelon:
Access the Carelon Provider Portal: Log in to the online portal through the Carelon website.
Patient Information: Enter the patient's name, date of birth, insurance details, and relevant medical history.
Select the Diagnostic Test: Choose the specific diagnostic test you want to request from the available options on the portal
Enter the requesting provider. search the NPI and the location. NOTE: Font is blue means it is valid if its red its inactive.
- Enter ICD-10 Diagnosis Codes: Provide the appropriate ICD-10 diagnosis codes that justify the need for the requested diagnostic test. 93303 is only required code click on the magnifying glass and then add exam
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CLINICAL SCENARIO: Signs, symptoms, or abnormal tests Click-Apply answer(s)
Clinical Details:
Select the reason for ordering this exam
Please select: Symptoms of heart disease (for example, shortness of breath or chest pain)
- Which symptoms have prompted the current request for echocardiography? (Select all that apply) Please select:
-Syncope
-Palpitations, dizziness or lightheadedness
Click on Apply answers.
- Does the patient have chest pain? ( please select the answers that applies towards the situation)
Yes
No
Unknown
Has an echocardiogram been performed since the onset of the symptoms?
Select: No
- The screen will prompt you to enter the facility of the place, please select the clinic, the patient will be seen. Then click continue
- Submit the Request: Review all information entered and submit the request electronically through the portal.
The next page will either approve the authorization or indicate that it is in progress. Please ensure to save the authorization in the patient's p-drive.
If the authorization is approved, the order ID will be displayed in light green. If it's in progress, it will be in yellow. Please take notes if it's still pending in the appointment notes and/or the superbill.
11/25/2024 DP