Prior Auth Required

58553 - Laparoscopy, surgical, with vaginal Prior Authorization Required Medical Necessity Including Site 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, with vaginal Prior Authorization Required Medical Necessity Including Site Submit History and Physical
Procedure / Service Description

hysterectomy, for uterus 250 g or less; with of Service documentation of medical necessity, - removal of tube(s) and/or ovary(s) operative report. No review required for gynecologic malignant conditions. 58553 Laparoscopy, surgical, with vaginal Prior Authorization Required Medical Necessity Including Site Submit History and Physical, hysterectomy, for uterus greater than 250 of Service documentation of medical necessity, grams 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.