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 />
58805 Drainage of ovarian cyst(s) All<br />
58820 Drainage of ovarian abscess All<br />
58822 Drainage of ovarian abscess All<br />
58823 Drainage of pelvic abscess All<br />
58825 Transposition, ovary(s) All<br />
58900 Biopsy of ovary(s) All<br />
58920 Partial removal of ovary(s) All<br />
58925 Removal of ovarian cyst(s) All<br />
58940 Removal of ovary(s) All<br />
58943 Removal of ovary(s) All<br />
58950 Resect ovarian malignancy All<br />
58951 Resect ovarian malignancy All<br />
58952 Resect ovarian malignancy All<br />
58953 Bilat. salpingo-ooppho : hysterec All<br />
58954 Hysterec /rem tubes/ovaries w/ rad dis All<br />
58956 Bso, omentectomy w/tah All<br />
58957 Resect recurrent gyn mal All<br />
58958 Resect recur gyn mal w/lym All<br />
58960 Exploration of abdomen All<br />
58999 Genital surgery procedure All<br />
59525 Remove uterus after cesarean All<br />
59840 Abortion All<br />
59841 Abortion All<br />
59850 Abortion All<br />
59851 Abortion All<br />
59852 Abortion All<br />
59855 Abortion All<br />
59856 Abortion All<br />
59857 Abortion All<br />
59897 Fetal Invas Px W/ Us All<br />
59898 Unlisted laparoscopy procedure, maternity<br />
care<br />
All<br />
59899 Maternity care procedure All<br />
60200 Remove thyroid lesion All<br />
60210 Partial excision thyroid All<br />
26994OH0812
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