Prior Auth Required

42950 - Pharyngoplasty (plastic or reconstructive Prior Authorization Required Medical Necessity Submit Site of Service, history and

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePharyngoplasty (plastic or reconstructive Prior Authorization Required Medical Necessity Submit Site of Service, history and
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - operative report if surgical) only for the date of service performed. 42950 Pharyngoplasty (plastic or reconstructive Prior Authorization Required Medical Necessity Submit Site of Service, history and operation on pharynx) physical, including sleep study results, results of CPAP trial. No review needed

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.