Prior Auth Required

0581T - Percutaneous cryoablation of malignant breast tumor All

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePercutaneous cryoablation of malignant breast tumor All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - CDP SOT with MCT/ADT 92549 All Substernal ICD system – implant/revision/removal/programming/remote 0571T, 0572T, 0573T, 0574T, 0575T, 0576T, 0577T, 0578T, 0579T, 0580T All Percutaneous cryoablation of malignant breast tumor 0581T All Transurethral ablation of malignant prostate tissue – water vapor 0582T All Tympanostomy with automated tube delivery, iontophoresis anesthesia 0583T All

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  • Submit clinical notes if requested by the plan
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  • Use the insurer authorization workflow for this listed code.