Prior Auth Required

19367 - Surgical - Breast Breast reconstruction; with single-pedicled transverse rectus

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceSurgical - Breast Breast reconstruction; with single-pedicled transverse rectus
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 4 - DIEP, SIEA, GAP flap) Surgical - Breast 19367 Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM)

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.