Prior Auth Required

53415 - Gender affirming codes – not covered for diagnosis of Gender Dysphoria); may be covered for other 11950, 11951, 11952, 11954, 15780, 15781, 15782, 15783, 15786, 15787, 15788, 15789, 15792, 15793, 15824, 15826, 15828, All

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / ServiceGender affirming codes – not covered for diagnosis of Gender Dysphoria); may be covered for other 11950, 11951, 11952, 11954, 15780, 15781, 15782, 15783, 15786, 15787, 15788, 15789, 15792, 15793, 15824, 15826, 15828, All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Gender affirming codes – not covered for diagnosis of Gender Dysphoria); may be covered for other 15775, 15776, 15820, 15821, 15822, 15823, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15847, 19316, All service/diagnosis 19340, 19342, 19350, 21193, 21194, 21195, 21196, 21208, 21209, 21210, 30400, 30410, 30420, 30430, 30435, 30450, 53400, 53405, 53410, 53415, 58661, 58700, 58953, 58956, 15772, 15773, S9128, G0153 Gender affirming codes – not covered for diagnosis of Gender Dysphoria); may be covered for other 11950, 11951, 11952, 11954, 15780, 15781, 15782, 15783, 15786, 15787, 15788, 15789, 15792, 15793, 15824, 15826, 15828, All service/diagnosis 15829, 15876, 15877, 15878, 15879, 21087, 21120, 21121, 21122, 21123, 21125, 21127, 21270, 21899, 31899, 40799, 67900

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.