Prior Auth Required

21493 - PR CLOSED RX 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 CLOSED RX NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2022
Procedure / Service Description

DISLOC NECESSITY - MANDIBLE SUPPORT MEDICAL DISLOC NECESSITY 21493 PR CLOSED RX NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2022 HYOID BONE AND DOCUMENTS TO FRACTURE 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.