Prior Auth Required

51137 - 22 CCR § .2, § .2; BPC §1200-1214, §1229, §1220; 42 USC 263a; Public Law 100-578; www.cms.gov; www.fda.gov

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service22 CCR § .2, § .2; BPC §1200-1214, §1229, §1220; 42 USC 263a; Public Law 100-578; www.cms.gov; www.fda.gov
Procedure / Service Description

Site Clinical Services Survey Criteria (Continued) Yes No N/A wt - Site Clinical Services Survey Criteria (Continued) Yes No N/A wt D. Site is compliant with Clinical Laboratory Improvement Amendment (CLIA) regulations. 22 CCR §51211.2, §51137.2; BPC §1200-1214, §1229, §1220; 42 USC 263a; Public Law 100-578; www.cms.gov; www.fda.gov 1. Laboratory test procedures are performed according to current site-specific CLIA certificate. 1 2. Testing personnel performing clinical lab procedures have been trained. 1

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.