Effective January 1, 2022 the following codes have been removed from our Prior Authorization grid. Every year prior authorization requirements are subject to change; some codes are added while others are removed. Please see our Prior Authorization grid to confirm whether a service requires a prior authorization.
| 64566 |
| E0651 |
| 62323 |
| 62321 |
| 62322 |
| 62324 |
| 62326 |
| 62325 |
| E1028 |
| G0277 |
| 99183 |
| 63688 |
| 65756 |
| 97606 |
| 97607 |
| 97608 |
| A9901 |
| A9900 |
| 37215 |
| 65730 |
| 65756 |
| 91110 |
| 91111 |
| E0265 |
| E0266 |
| E0296 |
| E0297 |
| E0745 |
| 28240 |
| C1884 |