Prior Auth Required

64744 - Potentially unproven

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServicePotentially unproven
Procedure / Service Description

Out-of-Network Services Advance notification required.Plan members who use out-of- - Potentially unproven 28890, 33289, 36514, 64405, 64722, 64744, 66180, 95965, 95966, services (including C2624 experimental/

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.