76499 - Unlisted diagnostic radiographic procedure Medical necessity review will be Medical Necessity Upon claims submission Medical

services and radiology report. - operative report if surgical) only for the date of service performed. 76499 Unlisted diagnostic radiographic procedure Medical necessity review will be Medical Necessity Upon claims submission Medical performed upon claims submission necessity review will be performed. with supporting documentation. Submit documentation to describe the

• Confirm benefit details
• Submit clinical notes if requested by the plan

• Confirm the current plan policy before submission.
• Use the insurer authorization workflow for this listed code.