Prior Auth Required
0195T - instrumentation, with image guidance, includes bone graft when performed; L5-S1 interspace
This procedure appears on the selected insurer prior authorization source.
Prior authorizationPrior Auth Required
Procedure / Serviceinstrumentation, with image guidance, includes bone graft when performed; L5-S1 interspace
Procedure / Service Description
Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without - 01942 kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without 0195T instrumentation, with image guidance, includes bone graft when performed; L5-S1 interspace Intra-fraction localization and tracking of target or patient motion during delivery of radiation 0197T therapy (eg, 3D positional tracking, gating, 3D surface tracking), each fraction of treatment
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.