Prior Auth Required

77438 - Surface radiation therapy; orthovoltage, Prior Authorization Required Radiation Oncology Submit online review with Carelon at

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceSurface radiation therapy; orthovoltage, Prior Authorization Required Radiation Oncology Submit online review with Carelon at
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 77438 Surface radiation therapy; orthovoltage, Prior Authorization Required Radiation Oncology Submit online review with Carelon at delivery, >150-500 KV, per fraction www.providerportal.com. For Prior Authorization: History and Physical,

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.