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 />
61596 Transcochlear approach/skull All<br />
61597 Transcondylar approach/skull All<br />
61598 Transpetrosal approach/skull All<br />
61600 Resect/excise cranial lesion All<br />
61601 Resect/excise cranial lesion All<br />
61605 Resect/excise cranial lesion All<br />
61606 Resect/excise cranial lesion All<br />
61607 Resect/excise cranial lesion All<br />
61608 Resect/excise cranial lesion All<br />
61609 Transect, artery, sinus All<br />
61610 Transect, artery, sinus All<br />
61611 Transect, artery, sinus All<br />
61612 Transect, artery, sinus All<br />
61613 Remove aneurysm, sinus All<br />
61615 Resect/excise lesion, skull All<br />
61616 Resect/excise lesion, skull All<br />
61618 Repair dura All<br />
61619 Repair dura All<br />
61623 Endovasc tempory vessel occl All<br />
61624 Occlusion/embolization cath All<br />
61626 Occlusion/embolization cath All<br />
61680 Intracranial vessel surgery All<br />
61682 Intracranial vessel surgery All<br />
61684 Intracranial vessel surgery All<br />
61686 Intracranial vessel surgery All<br />
61690 Intracranial vessel surgery All<br />
61692 Intracranial vessel surgery All<br />
61697 Brain aneurysm repr, complx All<br />
61698 Brain aneurysm repr, complx All<br />
61700 Inner skull vessel surgery All<br />
61702 Inner skull vessel surgery All<br />
61703 Clamp neck artery All<br />
61705 Revise circulation to head All<br />
61708 Revise circulation to head All<br />
61710 Revise circulation to head All<br />
26994OH0812