Prior Auth Required

0448T - 67299 0072T 0164T 0212T 0236T 0274T 0335T 0373T 0413T 0430T 0469T 0487T 0504T 0521T 0542T Q4195

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service67299 0072T 0164T 0212T 0236T 0274T 0335T 0373T 0413T 0430T 0469T 0487T 0504T 0521T 0542T Q4195
Procedure / Service Description

Experimental/Investigational - 31299 0055T 0111T 0209T 0231T 0271T 0329T 0357T 0410T 0427T 0446T 0484T 0501T 0518T 0535T Q4165 33440 0058T 0126T 0210T 0234T 0272T 0330T 0358T 0411T 0428T 0447T 0485T 0502T 0519T 0536T Q4189 33866 0071T 0163T 0211T 0235T 0273T 0333T 0362T 0412T 0429T 0448T 0486T 0503T 0520T 0541T Q4192 67299 0072T 0164T 0212T 0236T 0274T 0335T 0373T 0413T 0430T 0469T 0487T 0504T 0521T 0542T Q4195 82016 0075T 0165T 0213T 0237T 0275T 0338T 0394T 0414T 0431T 0470T 0488T 0505T 0522T A4563 Q4196

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.