Prior Auth Required

96549 - Unlisted chemotherapy 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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Procedure / ServiceUnlisted chemotherapy procedure Medical necessity review will be Medical Necessity Review required at claims submission
Procedure / Service Description

chemotherapy (HIPEC) procedure, documentation of medical necessity. - when performed; each additional 30 minutes 96549 Unlisted chemotherapy 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.