Prior Auth Required

0200T - Percutaneous sacral augmentation Prior Authorization Required Investigative Submit history and physical

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePercutaneous sacral augmentation Prior Authorization Required Investigative Submit history and physical
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - [Scianna blood group]) exons 4, 12 0200T Percutaneous sacral augmentation Prior Authorization Required Investigative Submit history and physical, (sacroplasty), unilateral injection(s), documentation of medical necessity and including the use of a balloon or procedure report.

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.