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54405 - Insertion of multi-component, inflatable Non-covered Service Benefit Exception Submit records only when member's

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceInsertion of multi-component, inflatable Non-covered Service Benefit Exception Submit records only when member's
Procedure / Service Description

transition/affirmation surgery unless - dysphoria diagnosis unless otherwise specified by contract. 54405 Insertion of multi-component, inflatable Non-covered Service Benefit Exception Submit records only when member's penile prosthesis, including placement of contract indicates coverage. Beginning pump, cylinders, and reservoir 1/1/22 code will require review for WA

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.