Prior Auth Required

21408 - PR OPEN RX FX NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2022

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePR OPEN RX FX NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2022
Procedure / Service Description

Effective Date - Effective Date 21408 PR OPEN RX FX NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2022 ORBIT W AND DOCUMENTS TO GRAFT 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.