Prior Auth Required

11054 - BPC §4172; 22 CCR § , § , § (a-g), § ; 21 CFR §1301.72, §1301.75, §1301.76, §1302; 16 CCR §1356.3; HSC §

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceBPC §4172; 22 CCR § , § , § (a-g), § ; 21 CFR §1301.72, §1301.75, §1301.76, §1302; 16 CCR §1356.3; HSC §
Procedure / Service Description

Site Clinical Services Survey Criteria Yes No N/A wt - Site Clinical Services Survey Criteria Yes No N/A wt A. Drugs and medication supplies are maintained secure to prevent unauthorized access. BPC §4172; 22 CCR §75032, §75033, §75037(a-g), §75039; 21 CFR §1301.72, §1301.75, §1301.76, §1302; 16 CCR §1356.3; HSC §11053-11058 1. Drugs are stored in specifically designated cupboards, cabinets, closets or drawers. 1 2. Prescription drug samples, and over-the-counter drugs, hypodermic needles/syringes, all medical sharp

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.