Prior Auth Required

15738 - 15776, 15780, 15781, 15782, 15783, 15788, 15789, 15792, 15793,

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service15776, 15780, 15781, 15782, 15783, 15788, 15789, 15792, 15793,
Procedure / Service Description

F64.0 F64.1 F64.2 F64.8 F64.9 Z87.890 - the following Dx codes: F64.0 F64.1 F64.2 F64.8 F64.9 Z87.890 14000, 14001, 14041, 15734, 15738, 15750, 15757, 15758, 15775, 15776, 15780, 15781, 15782, 15783, 15788, 15789, 15792, 15793, 19303, 21899, 31599, 31899, 53410, 53420, 53425, 53430, 54125,

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.