Prior Auth Required

21155 - &

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service&
Procedure / Service Description

• Services in attachment “A” that have covered indications - Removed codes 21141, 21142 21143, 21145 21146, 21147, 21150, 21151 21154, 21155 21159, 21160, 21188, 21196, & 21248 from policy and PA requirement. 11/1/2023 Added criteria for benign lesion removal

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.