Prior Auth Required

85542 - *Northern region includes: Apache, Coconino, Mohave, Navajo, Gila (excluding zip codes , , and ), and Yavapai

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service*Northern region includes: Apache, Coconino, Mohave, Navajo, Gila (excluding zip codes , , and ), and Yavapai
Procedure / Service Description

Statewide - Statewide Total 125 225 300 *Northern region includes: Apache, Coconino, Mohave, Navajo, Gila (excluding zip codes 85542, 85192, and 85550), and Yavapai **Southern region includes: Yuma, La Paz, Santa Cruz, Pima, Cochise, Graham (including zip codes 85542, 85192, 85550), Greenlee, and Pinal

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.