Prior Auth Required

54520 - Orchiectomy, simple (including 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 / ServiceOrchiectomy, simple (including Prior Authorization Required Medical Necessity Beginning 1/1/22 will only require review
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - irrigation and debridement of infected tissue 54520 Orchiectomy, simple (including Prior Authorization Required Medical Necessity Beginning 1/1/22 will only require review subcapsular), with or without testicular for WA members when submitted for prosthesis, scrotal or inguinal approach 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.