Prior Auth Required

58542 - Laparoscopy, surgical, supracervical Prior Authorization 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 / ServiceLaparoscopy, surgical, supracervical Prior Authorization Required Medical Necessity Submit History and Physical
Procedure / Service Description

hysterectomy, for uterus 250 g or less; documentation of medical necessity, - operative report. No review required for gynecologic malignant conditions. 58542 Laparoscopy, surgical, supracervical Prior Authorization Required Medical Necessity Submit History and Physical, hysterectomy, for uterus 250 g or less; with documentation of medical necessity, removal of tube(s) and/or ovary(s) operative report. No review required for

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.