Removal of prior authorization for certain services is part of our continued efforts to make the prior authorization process more efficient and transparent. Our goal is to enhance the provider experience by making it easier for providers to navigate the prior authorization process, helping ensure timely member access to necessary services. 


Beginning 4/24/24, the procedure codes listed in Table 1 do not require prior authorization

 

Table 1 Prior Authorization NOT Required

CPT/HCPCS Codes

Description

E0603

Breast Pumps

H1000

Prenatal Risk Assessment

17110, 17111 (DX B07)

Wart Removal

54360, 54380, 54385, 54390

Penile Torsion Repair

55867

Radical Prostatectomy

64455

Digital Blocks

77012

CT or MRI Guidance

 
Prior authorization is required for the codes listed in Table 2, below: 
 

Table 2 Prior Authorization Required

CPT/HCPCS Codes

Description

93740

Thermography Temp Gradient Studies

S8080

Scintimammography

 

As a reminder, to verify whether a service requires prior authorization, use the Prior Authorization Lookup Tool on the provider website. Remember, you can save time by submitting your medical authorizations electronically via NaviNet.


Questions? Please contact your Provider Account Executive or call Provider Services at 

1-833-644-6001.

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