Prior Auth Required

72040 - CHG RADEX NO AUTHORIZATION REQUIRED MD GUIDELINE 1 (Mobile X Ray CLINICAL INFORMATION C, S, SK CP 2/1/2024

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceCHG RADEX NO AUTHORIZATION REQUIRED MD GUIDELINE 1 (Mobile X Ray CLINICAL INFORMATION C, S, SK CP 2/1/2024
Procedure / Service Description

PEND, MRI SEDATION NON - 72040 CHG RADEX NO AUTHORIZATION REQUIRED MD GUIDELINE 1 (Mobile X Ray CLINICAL INFORMATION C, S, SK CP 2/1/2024 SPINE Guideline): AND DOCUMENTS TO CERVICAL 2 OR EXCLUSIONS: MOBILE https://driscollhealthplan.com/prior 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.