Prior Auth Required

0791T - Motor-cognitive, semi-immersive virtual Retrospective Review Outpatient Rehabilitation For Alaska plans: After initial visit, submit

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceMotor-cognitive, semi-immersive virtual Retrospective Review Outpatient Rehabilitation For Alaska plans: After initial visit, submit
Procedure / Service Description

electrode array, sacral, with integrated documentation of medical necessity. - electrode array, sacral, with integrated documentation of medical necessity. neurostimulator 0791T Motor-cognitive, semi-immersive virtual Retrospective Review Outpatient Rehabilitation For Alaska plans: After initial visit, submit reality-facilitated gait training, each 15 online review at www.evicore.com. For minutes (List separately in addition to code Washington plans: After the first 6

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.