Prior Auth Required

80204 - CHG DRUG NO AUTHORIZATION REQUIRED 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 DRUG NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2024
Procedure / Service Description

ZONISAMIDE NECESSITY - QUANTITATIVE SUPPORT MEDICAL ZONISAMIDE NECESSITY 80204 CHG DRUG NO AUTHORIZATION REQUIRED CLINICAL INFORMATION C, S, SK CP 2/1/2024 ASSAY AND DOCUMENTS TO METHOTREXAT 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.