Prior Auth Required

21240 - Not Required Required Not Required Not Required Required Required

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceNot Required Required Not Required Not Required Required Required
Procedure / Service Description

HMO) - 21195 Required Required Required Required Required Required 21198 Required Required Required Required Required Required 21240 Not Required Required Not Required Not Required Required Required 21242 Not Required Not Required Not Required Not Required Required Required 21243 Not Required Required Not Required Not Required Required Required

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.