Prior Auth Required

77373 - Stereotactic body radiation therapy, 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 body radiation therapy, 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 77373 Stereotactic body radiation therapy, Prior Authorization Required Radiation Oncology No review for non-cancer diagnoses. treatment delivery, per fraction to 1 or more FOR CANCER DIAGNOSES ONLY: lesions, including image guidance, entire 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.