Prior Auth Required

22630 - 21142 22207 22632 22864 28010 28153 28291 28735 29885 32994 34713 38207 43886 58152 58548 58958 63030 63102 95249 S2095

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service21142 22207 22632 22864 28010 28153 28291 28735 29885 32994 34713 38207 43886 58152 58548 58958 63030 63102 95249 S2095
Procedure / Service Description

Prior Authorization Codification List - 21138 22114 22610 22857 27487 28130 28286 28715 29882 31660 33274 37780 43848 57289 58544 58954 63016 63090 90867 C9746 21139 22116 22612 22861 28005 28140 28288 28725 29883 31661 33275 37785 43881 58150 58545 58956 63017 63091 90868 C9747 21141 22206 22630 22862 28008 28150 28289 28730 29884 32491 33979 38204 43882 58180 58546 58957 63020 63101 90869 C9748 21142 22207 22632 22864 28010 28153 28291 28735 29885 32994 34713 38207 43886 58152 58548 58958 63030 63102 95249 S2095 21143 22208 22633 22865 28011 28160 28292 28737 29886 33206 34714 38208 43887 58200 58550 58970 63035 63103 93229

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.