Prior Auth Required

57291 - Gender Affirming Surgery Gender affirming surgery – Male to Female , , , , , , , , , , , , , , , , , All

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceGender Affirming Surgery Gender affirming surgery – Male to Female , , , , , , , , , , , , , , , , , All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Pain propensity RNA expression risk score (36 genes) 0289U All Oncology (thyroid) mRNA gene expression profiling 0287U All Gender Affirming Surgery Gender affirming surgery – Male to Female 53430, 54125, 54520, 54690, 55866, 55970, 56800, 56805, 57291, 57292, 57295, 57296, 57335, 57426, 58999, 15772, 15773, All 19325, 31599, 17380, 17999 Gender affirming surgery – Female to Male 19303, 19302, 19300, 19318, 53420, 53425, 53430, 54400, 54401, 54405, 54660, 55175, 55180, 15200, 31599, 17380, 17999, All

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.