CPT Codes Requiring Prior Authorization - Molina Healthcare
CPT Codes Requiring Prior Authorization - Molina Healthcare
CPT Codes Requiring Prior Authorization - Molina Healthcare
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Procedure<br />
Code<br />
<strong>CPT</strong> <strong>Codes</strong> <strong>Requiring</strong><br />
<strong>Prior</strong> <strong>Authorization</strong><br />
Service Description PA Required by POS<br />
35305 Rechanneling of artery All<br />
35306 Rechanneling of artery All<br />
35311 Rechanneling of artery All<br />
35321 Rechanneling of artery All<br />
35331 Rechanneling of artery All<br />
35341 Rechanneling of artery All<br />
35351 Rechanneling of artery All<br />
35355 Rechanneling of artery All<br />
35361 Rechanneling of artery All<br />
35363 Rechanneling of artery All<br />
35371 Rechanneling of artery All<br />
35372 Rechanneling of artery All<br />
35390 Reoperation, carotid All<br />
35400 Angioscopy All<br />
35450 Repair arterial blockage All<br />
35452 Repair arterial blockage All<br />
35458 Repair arterial blockage All<br />
35460 Repair venous blockage All<br />
35471 Repair arterial blockage All<br />
35472 Repair arterial blockage All<br />
35475 Repair arterial blockage All<br />
35476 Repair venous blockage All<br />
35495 Atherectomy, percutaneous All<br />
35500 Vein harvest All<br />
35501 Artery bypass graft All<br />
35506 Artery bypass graft All<br />
35508 Artery bypass graft All<br />
35509 Artery bypass graft All<br />
35510 Artery Bypass Graft All<br />
35511 Artery bypass graft All<br />
35512 Artery Bypass Graft All<br />
35515 Artery bypass graft All<br />
35516 Artery bypass graft All<br />
35518 Artery bypass graft All<br />
35521 Artery bypass graft All<br />
26994OH0812