Prior authorization codes
Sutter Health Plus
Active CPT codes that appear on the extracted prior authorization list for this health plan.
| Code | Procedure / Service | Effective | Revised | Confidence | Source |
|---|---|---|---|---|---|
| D0120 | 8. Refers to procedure codes and / | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D0999 | 5. Refers to procedure code procedures in this category cannot exceed the stated amount | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D1110 | 8. Refers to procedure codes and / | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D1120 | 8. Refers to procedure codes and / | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D2140 | 1. Refers to procedure code 14. Certain prosthetics, orthotics and devices may be available at no cost (after | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D3330 | 2. Refers to procedure code deductible, if deductible applies). Please refer to the Evidence of Coverage for | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D8080 | 9. Refers to procedure code / | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |
| D8090 | 9. Refers to procedure code / | 2026-07-06 | Not listed | 97% | [PDF] BENEFIT SUMMARIES - Rogers Benefit Group |