Prior Auth Required

67028 - Investigational Intravitreal injection of a pharmacologic agent (separate

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceInvestigational Intravitreal injection of a pharmacologic agent (separate
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 56 - Investigational 67028 Intravitreal injection of a pharmacologic agent (separate Potential procedure) [when specified as refill

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.