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.
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Table 1 Prior Authorization NOT Required
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CPT/HCPCS Codes
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Description
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E0603
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Breast Pumps
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H1000
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Prenatal Risk Assessment
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17110, 17111 (DX B07)
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Wart Removal
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54360, 54380, 54385, 54390
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Penile Torsion Repair
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55867
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Radical Prostatectomy
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64455
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Digital Blocks
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77012
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CT or MRI Guidance
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Prior authorization is required for the codes listed in Table 2, below:
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Table 2 Prior Authorization Required
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CPT/HCPCS Codes
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Description
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93740
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Thermography Temp Gradient Studies
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S8080
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Scintimammography
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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.