Prior Auth Required

23420 - Reconstruction of complete shoulder Prior Authorization Required Medical Necessity No review needed for member age 18

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceReconstruction of complete shoulder Prior Authorization Required Medical Necessity No review needed for member age 18
Procedure / Service Description

of medical necessity including for site of - of medical necessity including for site of service. 23420 Reconstruction of complete shoulder Prior Authorization Required Medical Necessity No review needed for member age 18 (rotator) cuff avulsion, chronic (includes and under. Submit recent history and acromioplasty) physical, plan of care, and documentation

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.