Prior Auth Required

99455 - Work related or medical disability Non-covered Service Benefit Exception Considered non-covered unless

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceWork related or medical disability Non-covered Service Benefit Exception Considered non-covered unless
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 99455 Work related or medical disability Non-covered Service Benefit Exception Considered non-covered unless examination by the treating physician that member's contract indicates coverage. includes: Completion of a medical history

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.