Prior Auth Required

77439 - 844-926-4528, option 5, for

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service844-926-4528, option 5, for
Procedure / Service Description

Category Subcategory/notes Codes and comments - on Evolent’s website 77423, 77424, 77425, or by calling Evolent at 77436, 77437, 77438, 844-926-4528, option 5, for 77439, 77520, 77522, Surgical Services. You can 77523, 77525,77750, speak to a live representative 77761, 77762, 77763,

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.