Prior Auth Required

63621 - Stereotactic radiosurgery (particle beam, Prior Authorization Required Radiation Oncology No review for non-cancer diagnoses

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceStereotactic radiosurgery (particle beam, Prior Authorization Required Radiation Oncology No review for non-cancer diagnoses
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 63621 Stereotactic radiosurgery (particle beam, Prior Authorization Required Radiation Oncology No review for non-cancer diagnoses. gamma ray, or linear accelerator); each FOR CANCER DIAGNOSES ONLY: additional spinal lesion (List separately in Submit online review with Carelon at

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.