Prior Auth Required

77301 - Radiation Intensity Modulated Radiotherapy Plan W/Dose Volume Histograms

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceRadiation Intensity Modulated Radiotherapy Plan W/Dose Volume Histograms
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 62 - prescribed by the treating physician Radiation 77301 Intensity Modulated Radiotherapy Plan W/Dose Volume Histograms

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.