Prior Auth Required

96367 - Pharmacy Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePharmacy Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 97 - diagnosis (specify substance or drug); each additional hour Pharmacy 96367 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new

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.