Prior Auth Required

63196 - 63265-63268, 63270-63273, 63275-63278, 63280-63283, 63285-63287, 63290

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service63265-63268, 63270-63273, 63275-63278, 63280-63283, 63285-63287, 63290
Procedure / Service Description

Intradiscal Procedures (TIPs) NCD - 63091, 63101, 63102, 63103 63170, 63172, 63173, 63185, 63190, 63191, 63194-63200, 63250-63252, 63265-63268, 63270-63273, 63275-63278, 63280-63283, 63285-63287, 63290

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.