Prior Auth Required

15004 - PR WND PREP NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 12/1/2023

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServicePR WND PREP NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 12/1/2023
Procedure / Service Description

ADDL 100 CM NECESSITY - TRK/ARM/LG SUPPORT MEDICAL ADDL 100 CM NECESSITY 15004 PR WND PREP NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 12/1/2023 PED, AND DOCUMENTS TO FACE/NCK/HND SUPPORT MEDICAL

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.