Prior Auth Required

94799 - Unlisted pulmonary service or procedure Medical necessity review will be Medical Necessity Review required at claims submission

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceUnlisted pulmonary service or procedure Medical necessity review will be Medical Necessity Review required at claims submission
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - operative report if surgical) only for the date of service performed. 94799 Unlisted pulmonary service or procedure Medical necessity review will be Medical Necessity Review required at claims submission; performed upon claims submission submit description of procedure with with supporting documentation. supporting documentation (including

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.