Prior Auth Required

64704 - 19366 23472 29828 31295 36478 43275 51845 57288 61781 64708 69604 72158 74183 78650 93454

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service19366 23472 29828 31295 36478 43275 51845 57288 61781 64708 69604 72158 74183 78650 93454
Procedure / Service Description

Pre-Authorization List 2018 - 19342 22854 29825 31276 33282 43259 49999 56620 60220 64590 67908 72149 74175 78473 93451 19350 22859 29826 31287 36475 43264 57240 60240 64702 67921 72156 74177 78492 93452 19357 22902 29827 31288 36476 43274 50590 57260 61623 64704 68320 72157 74182 78608 93453 19366 23472 29828 31295 36478 43275 51845 57288 61781 64708 69604 72158 74183 78650 93454 19370 27130 29875 31296 37224 43276 51860 57425 61796 65730 69641 72195 75561 78707 93455

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.