{"id":10348,"date":"2021-01-21T12:31:54","date_gmt":"2021-01-21T18:31:54","guid":{"rendered":"https:\/\/countycare1.wpenginepowered.com\/?page_id=10348"},"modified":"2026-03-25T10:22:49","modified_gmt":"2026-03-25T15:22:49","slug":"clinical-criteria-for-prior-authorizations","status":"publish","type":"page","link":"https:\/\/countycare.com\/es\/providers\/clinical-criteria-for-prior-authorizations\/","title":{"rendered":"Criterios cl\u00ednicos para autorizaciones previas"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"10348\" class=\"elementor elementor-10348\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e595701 e-flex e-con-boxed e-con e-parent\" data-id=\"e595701\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-980b8ae elementor-widget elementor-widget-heading\" data-id=\"980b8ae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Criterios cl\u00ednicos para autorizaciones previas<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ac193ec e-con-full e-flex e-con e-parent\" data-id=\"ac193ec\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5ba858c elementor-widget elementor-widget-text-editor\" data-id=\"5ba858c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Enhanced Respiratory Care (ERC)<\/strong><\/p><p><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ERC-Chicago_Hospital-Flyer_Final-2.20.24.pdf\">ERC Hospital Flyer<\/a><\/p><p><strong>Pautas cl\u00ednicas de farmacia<\/strong><\/p><ul><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/CountyCare-UM-Policies-Portfolio-Jan2026-1.pdf\">Directrices de autorizaci\u00f3n previa de los sistemas de atenci\u00f3n m\u00e9dica y hospitales del condado de Cook<\/a><\/li><li><a href=\"https:\/\/www.newcenturyhealth.com\/compliance-and-regulatory-information\/\" target=\"_blank\" rel=\"noopener\">Pol\u00edticas de medicamentos de New Century Health<\/a><\/li><\/ul><p><strong>Pol\u00edticas y Procedimientos Cl\u00ednicos<\/strong><\/p><ul><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2702.CC-for-Transplant-Lung-and-Lobar-Lung-ver-Nov-25.pdf\">ECG_2702.CC for Transplant: Lung and Lobar Lung<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2704.CC-for-Gene-Expression-Testing-for-Breast-Cancer-ver-Nov-25.pdf\">ECG_2704.CC for Gene Expression Testing Breast Cancer<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2707.CC-for-Bariatric-Surgery-ver-Mar-26.pdf\">ECG_2707.CC for Bariatric Surgery<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2710.CC-for-Nutritional-Support-ver-Nov-25.pdf\">ECG_2710.CC for Nutritional Support<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2711.CC-for-Clinical-Trials-ver-Nov-25.pdf\">ECG_2711.CC for Clinical Trials<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2712.CC-Experimental-and-Investigational-Services-ver-Nov-25.pdf\">ECG_2712.CC for Experimental and Investigational Services<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2714.CC-for-Peer-to-Peer-Review-Process-ver-Nov-25.pdf\">ECG_2714.CC for Peer-to-Peer Review Process<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2715.CC-for-Genetic-Testing-ver-Nov-25.pdf\">ECG_2715.CC for Genetic Testing<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2719.CC-for-Surgical-Management-of-Gender-Dysphoria-ver-Nov-25.pdf\">ECG_2719.CC for Surgical Management of Gender Dysphoria<\/a><\/li><li>E<a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2720.CC-for-Definitive-Quantitative-Urine-Drug-Testing-ver-Nov-25.pdf\">CG_2720.CC for Definitive (Quantitative) Urine Drug Testing<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2723.CC-for-Car-T-Therapy-ver-Nov-25.pdf\">ECG_2723.CC for Car-T Therapy<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2724.CC-for-Authorization-for-Observation-vs.-Inpatient-Admission-Level-of-Care-ver-Nov-25.pdf\">ECG_2724.CC for Authorization for Observation versus Inpatient Admission Level of Care<\/a><ul><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2724.CC-for-IP-to-OBS-Diagnosis-Codes.xlsx\">ECG_2724.CC for IP to OBS Diagnosis Codes<\/a><\/li><\/ul><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2725.CC-for-Cognitive-Performance-Testing-ver-Nov-25.pdf\">ECG_2725.CC for Cognitive Performance Testing<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2726.CC-for-Community-Support-Services-ver-Nov-25.pdf\">ECG_2726.CC for Community Support Services<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2727.CC-for-Neurobehavioral-Status-Exam-ver-Nov-25.pdf\">ECG_2727.CC for Neurobehavioral Status Exam<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2728.CC-for-Psychosocial-Rehabilitation-ver-Nov-25.pdf\">ECG_2728.CC for Psychosocial Rehabilitation<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2729.CC-for-Targeted-Case-Management-ver-Nov-25.pdf\">ECG_2729.CC for Targeted Case Management<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2731.CC-for-Human-Donor-Milk-ver-Nov-25.pdf\">ECG_2731.CC for Human Donor Milk<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2732.CC-for-Post-Acute-Level-of-Care-PAC-ver-Nov-25.pdf\">ECG_2732.CC for Post Acute Level of Care (PAC)<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2734.CC-for-Outpatient-Major-Joint-Arthroplasy-Hips-and-Knees-ver-Dec-25.pdf\">ECG_2734.CC for Outpatient Major Joint Arthroplasty (Hips and Knees)<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2735.CC-for-Site-of-Service-ver-Nov-25.pdf\">ECG_2735.CC for Site of Service<\/a><ul><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2735.CC-for-Site-of-Service.xlsx\">Site of Service Codes in relation to ECG_2735.CC for Site of Service\u00a0<\/a><\/li><\/ul><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2736.CC-for-Non-Invasive-Genetic-Testing-During-Pregnancy-ver-Nov-25.pdf\">ECG_2736.CC for Non-Invasive Genetic Testing During Pregnancy<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2737.CC-for-Fertility-Preservation-for-Iatrogenic-Infertility-ver-Dec-25.pdf\">ECG_2737.CC for Fertility Preservation for Iatrogenic Infertility<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2738.CC-for-Determination-of-Medical-Necessity-ver-Nov-25.pdf\">ECG_2738.CC for Determination of Medical Necessity<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2739.CC-for-Utilization-Review-Process-ver-Nov-25.pdf\">ECG_2739.CC for Utilization Review Process<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2740.CC-for-Definitions-ver-Feb-26.pdf\">ECG_2740.CC for Definitions<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/ECG_2741.CC-for-Administrative-Days-Requests-ver-Nov-25.pdf\">ECG_2741.CC for Administrative Days Requests<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/EMP_2515.CC-for-Cosmetic-and-Reconstructive-Procedures-ver-Nov-25.pdf\">EMP_2515.CC for Cosmetic versus Reconstructive Services<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/eviCore-PA-list-for-DME-effective-11.1.23-Final.xlsx\">eviCore PA List Effective 11.01.23<\/a><\/li><li>Consulte los c\u00f3digos de diagn\u00f3stico y procedimiento para el parto electivo<ul><li style=\"list-style-type: none;\"><ul><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/Elective-Deliveries-GA-_High-Risk-Dx-Codes-11.15.24.xlsx\">Elective-Deliveries-GA-_High-Risk-Dx-Codes-Effective-11.15.24<\/a><\/li><li><a href=\"https:\/\/countycare.com\/wp-content\/uploads\/GA-and-HR-Diagnosis-and-Procedure-Codes-Effective-10_6_22.xlsx\">GA y HR Diagn\u00f3stico-y-C\u00f3digos-de-Procedimiento-Efectivo 10_6_22<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><p><a href=\"https:\/\/countycare.com\/es\/providers\/medical-drug-policies-for-prior-authorization\/\"><strong>Pol\u00edticas de Medicamentos para Autorizaci\u00f3n Previa<\/strong><\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Clinical Criteria for Prior Authorizations Enhanced Respiratory Care (ERC) ERC Hospital Flyer Pharmacy Clinical Guidelines Cook County Healthcare and Hospitals Systems Prior Authorization Guidelines New Century Health Drug Policies Clinical Policies and Procedures ECG_2702.CC for Transplant: Lung and Lobar Lung ECG_2704.CC for Gene Expression Testing Breast Cancer ECG_2707.CC for Bariatric Surgery ECG_2710.CC for Nutritional Support [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":9521,"parent":7365,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"iawp_total_views":4453,"footnotes":""},"class_list":["post-10348","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/pages\/10348","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/comments?post=10348"}],"version-history":[{"count":0,"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/pages\/10348\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/pages\/7365"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/media\/9521"}],"wp:attachment":[{"href":"https:\/\/countycare.com\/es\/wp-json\/wp\/v2\/media?parent=10348"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}