Prior Auth Required

0201T - 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

(sacroplasty), unilateral injection(s), documentation of medical necessity and - genotyping (XK), gene analysis, XK (X- Optional linked Kx blood group) exons 1-3 0201T Percutaneous sacral augmentation Prior Authorization Required Investigative Submit history and physical, (sacroplasty), bilateral injections, including documentation of medical necessity and the use of a balloon or mechanical device, 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.