Prior Auth Required

57110 - 57296, 57335, 57426,58661, 58720, 58940, 64856, 64892, 64896,

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service57296, 57335, 57426,58661, 58720, 58940, 64856, 64892, 64896,
Procedure / Service Description

F64.0 F64.1 F64.2 F64.8 F64.9 Z87.890 - 19303, 21899, 31599, 31899, 53410, 53420, 53425, 53430, 54125, 54400, 54401, 54405, 54408, 54520, 54660, 54690, 55175, 55180, 55866, 56625, 56800, 56805, 57106, 57110, 57291, 57292, 57295, 57296, 57335, 57426,58661, 58720, 58940, 64856, 64892, 64896, 92507, 92508

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.