Prior Auth Required

58573 - Laparoscopy, surgical, with total 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, with total Prior Authorization Required Medical Necessity Submit History and Physical
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - medical service or supply. Code Description Plan Review Requirement Reviewed For Records Request 58573 Laparoscopy, surgical, with total Prior Authorization Required Medical Necessity Submit History and Physical, hysterectomy, for uterus greater than 250 documentation of medical necessity, g; with 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.