Table of Contents
- Section 6 - Forms pg.358
- Notice of Authorization (NOA) (DC-301, Rev. 4/20)
- Resubmission Turnaround Document (RTD) (DC-102, Rev. 10/19) pg.393
- Claim Inquiry Form (CIF) (DC-003, Rev. 10/19)
- Claim Inquiry Response (CIR) pg.401
- Checklists
- Justification of Need for Prosthesis (DC054, Rev 9/18)
- Explanation of Benefits (EOB)
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