Prior Auth Required

21267 - 21740, 21742, 21743, 28344, 30540, 30545, 30560, 30620, 31295,

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service21740, 21742, 21743, 28344, 30540, 30545, 30560, 30620, 31295,
Procedure / Service Description

HCPCS code. Notification required for injectable chemotherapy - reconstructive procedures 15878, 15879, 17106, 17107, 17108, 17999, 21172, 21175, 21179, 21180, 21181, 21182, 21183, 21184, 21230, 21235, 21248, 21249, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21275, 21299, 21740, 21742, 21743, 28344, 30540, 30545, 30560, 30620, 31295, 31296, 31297, 31298, 31299, 67900, 67901, 67902, 67903, 67904,

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.