Prior Auth Required

77763 - Therapy

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceTherapy
Procedure / Service Description

Prior Authorization List - Proton Beam Therapy, These services require prior authorization. Together with CCHP may have a case 32701; 55920; 61796; 61797; 61798; 61799; 61800; 63620; 63621; 77316; Brachytherapy, and Radiation manager contact the member to help coordinate care during this difficult treatment. 77317; 77318; 77371; 77372; 77373; 77520; 77522; 77523; Therapy 77525; 77761; 77762; 77763; 77767; 77768; 77770; 77771; 77772; 77778;77790; Please complete the Case / Disease Management Referral Form for the member. 77799; 79999; C1716; C1717; C1719; C2616; C2634; C2635; C2636; C2637;

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.