Prior Auth Required

40527 - Excision of lip; full thickness, Prior Authorization Required Medical Necessity Beginning 1/1/22 will only require review

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceExcision of lip; full thickness, Prior Authorization Required Medical Necessity Beginning 1/1/22 will only require review
Procedure / Service Description

documentation of medical necessity and - procedure report. 40527 Excision of lip; full thickness, Prior Authorization Required Medical Necessity Beginning 1/1/22 will only require review reconstruction with cross lip flap (Abbe- for WA members when submitted for Estlander) gender transition/affirmation surgery.

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.