Prior Auth Required

58210 - 21146 22212 22634 22868 28060 28173 28296 28750 29888 33208 34716 38210 47380 58240 58553 58976 63042 64568 96570

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service21146 22212 22634 22868 28060 28173 28296 28750 29888 33208 34716 38210 47380 58240 58553 58976 63042 64568 96570
Procedure / Service Description

Prior Authorization Codification List - 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 21145 22210 22614 22867 28035 28171 28295 28740 29887 33207 34715 38209 43888 58210 58552 58974 63040 64553 96567 21146 22212 22634 22868 28060 28173 28296 28750 29888 33208 34716 38210 47380 58240 58553 58976 63042 64568 96570 21147 22214 22800 22869 28062 28175 28297 28755 29889 33212 36460 38211 47381 58260 58554 59070 63043 64569 96571

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.