Prior Auth Required

63057 - Transpedicular approach with Prior Authorization Required Medical Necessity Including Site Submit Site of Service, History and

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceTranspedicular approach with Prior Authorization Required Medical Necessity Including Site Submit Site of Service, History and
Procedure / Service Description

herniated intervertebral disc) Services (IHS) facilities. No review - needed for members under age 18. 63057 Transpedicular approach with Prior Authorization Required Medical Necessity Including Site Submit Site of Service, History and decompression of spinal cord, equina of Service Physical, prior back surgeries, including and/or nerve root(s) (eg, herniated minimally invasive, conservative

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.