Prior Auth Required

19396 - Surgical - Breast Preparation of moulage for custom breast implant

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceSurgical - Breast Preparation of moulage for custom breast implant
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 4 - implant-based reconstruction) Surgical - Breast 19396 Preparation of moulage for custom breast implant Procedure - Oncology 19499 Unlisted procedure, breast [when specified as destruction of breast

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.