Prior Auth Required

89261 - Infertility Sperm isolation; complex prep (eg, Percoll gradient, albumin

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceInfertility Sperm isolation; complex prep (eg, Percoll gradient, albumin
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 94 - insemination or diagnosis with semen analysis Infertility 89261 Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis

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.