Prior Auth Required

58672 - Laparoscopy, surgical; with fimbrioplasty Prior Authorization Required Medical Necessity Submit History and Physical

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceLaparoscopy, surgical; with fimbrioplasty Prior Authorization Required Medical Necessity Submit History and Physical
Procedure / Service Description

hysterectomy, for uterus greater than 250 documentation of medical necessity, - operative report if surgical) only for the date of service performed. 58672 Laparoscopy, surgical; with fimbrioplasty Prior Authorization Required Medical Necessity Submit History and Physical, documentation of medical necessity, operative report

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.