Prior Auth Required

0964T - Impression and custom preparation of jaw Prior Authorization Required Sleep Devices and Equipment Submit online review with Carelon at

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceImpression and custom preparation of jaw Prior Authorization Required Sleep Devices and Equipment Submit online review with Carelon at
Procedure / Service Description

specimen (List separately in addition to - qualified health care professional 0964T Impression and custom preparation of jaw Prior Authorization Required Sleep Devices and Equipment Submit online review with Carelon at expansion oral prosthesis for obstructive www.providerportal.com. For Prior sleep apnea, including initial adjustment; Authorization: History and Physical,

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.