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Home → Welfare→ SPD → 6.5.1 WHAT SERVICES AND PROCEDURES REQUIRE PRECERTIFICATION OR PRE-SU 
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6.5.1
WHAT SERVICES AND PROCEDURES REQUIRE PRECERTIFICATION OR
PRE-SURGICAL REVIEW
- Precertification Review
is required for all non-Emergency inpatient Hospital admissions
- Pre-surgical Review is
required for the following surgical procedures:
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Knee surgery
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Rhinoplasty (nose bone surgery)
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Bunionectomy and/or hammertoe (multiple)
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Septoplasty (nose cartilage surgery)
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Jaw surgery
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Varicose vein surgery
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- Precertification Review
is required for Home Health Services.
- Precertification Review
IS REQUIRED for Emergency inpatient hospitalization.
If an Emergency requires admittance into the Hospital,
the Utilization Management Organization must be contacted
within 72 hours. Your Physician, a family member or friend
can make that phone call. This will enable the Utilization
Management Organization to advise you on the Medical Necessity
of health services.
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