Prior Auth Required

13046 - Paper adjustment requests must be submitted using the Adjustment/Reconsideration Request (F- (07/12)) form

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePaper adjustment requests must be submitted using the Adjustment/Reconsideration Request (F- (07/12)) form
Procedure / Service Description

Paper - Paper Paper adjustment requests must be submitted using the Adjustment/Reconsideration Request (F-13046 (07/12)) form. Topic #816

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.