Prior Auth Required

72128 - Click here for additional Click here for additional (CT) 72131, 72132, 72133, 72141,

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceClick here for additional Click here for additional (CT) 72131, 72132, 72133, 72141,
Procedure / Service Description

radiology-guidelines/ radiology-guidelines/ - • Computed 71271, 71275, 71550, 71551, tomography 71552, 71555, 72125, 72126, 72127, 72128, 72129, 72130, Click here for additional Click here for additional (CT) 72131, 72132, 72133, 72141, information on Carelon information on Carelon • Low-dose CT 72142, 72146, 72147, 72148,

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.