Prior Auth Required

22630 - 19318 22633 29823 31256 33264 43246 49657 54416 58662 63685 67900 72147 74170 78454 92928

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service19318 22633 29823 31256 33264 43246 49657 54416 58662 63685 67900 72147 74170 78454 92928
Procedure / Service Description

Pre-Authorization List 2018 - CPT/HCPCS Codes #15823 – #93970 Continued on page 3 15823 22630 29822 31255 33263 43244 49656 54410 58661 63664 67039 72146 73723 78452 91110 19318 22633 29823 31256 33264 43246 49657 54416 58662 63685 67900 72147 74170 78454 92928 19340 22853 29824 31267 33270 43247 49659 55866 64555 67903 72148 74174 78472 93306

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.