Prior Auth Required

75038 - BPC §4024, §4076, §4170, §4171, §4173, §4174; 22 CCR § , § , § , § (a-g), § , § ; 16 CCR §1718.1; 21 CFR §211.137; 42 USC

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / ServiceBPC §4024, §4076, §4170, §4171, §4173, §4174; 22 CCR § , § , § , § (a-g), § , § ; 16 CCR §1718.1; 21 CFR §211.137; 42 USC
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 C. Drugs are dispensed according to State and federal drug distribution laws and regulations. BPC §4024, §4076, §4170, §4171, §4173, §4174; 22 CCR §75032, §75033, §75036, §75037(a-g), §75038, §75039; 16 CCR §1718.1; 21 CFR §211.137; 42 USC 6A §300AA-26; CDC Recommendations; DHCS Contract; All Plan Letter 18-004; BPC §4000 et seq (Pharmacy Law); §4170; HSC §11000-11651 (Uniform Controlled Substances Act)  

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.