Prior Auth Required

31242 - Nasal/sinus endoscopy, surgical; with Pre-Service Review Required Medical Necessity Submit history and physical

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceNasal/sinus endoscopy, surgical; with Pre-Service Review Required Medical Necessity Submit history and physical
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - 3109 Other Adult Care Non-covered Service Benefit Exception Considered non-covered unless member's contract indicates coverage. 31242 Nasal/sinus endoscopy, surgical; with Pre-Service Review Required Medical Necessity Submit history and physical, destruction by radiofrequency ablation, documentation of medical necessity. posterior nasal nerve

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.