Peach State Health Plan prior authorization, page 66
CPT code lookup
Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.
Prior authorization codes
| Code | Description | Source |
|---|---|---|
| 89346 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 89352 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 89353 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 89354 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 89356 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 89398 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| C9507 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| G0146 | Laboratory - Chemistry, Hematology, and Blood Bank | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| G0327 | Laboratory - Chemistry, Hematology, and Specimen Collection | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80324 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80325 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80326 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80345 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80346 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80347 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80353 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80358 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80361 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80362 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80363 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80364 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80369 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 80370 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 87154 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 87913 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| G0480 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| G0481 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| G0482 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| G0483 | Microscopic examination (bacterial, toxicology, COVID- 19) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0751T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0752T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0753T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0754T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0755T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0756T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0757T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0758T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0759T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0760T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0761T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0762T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 0763T | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88230 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88233 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88235 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88237 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88239 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88240 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88241 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |
| 88245 | Pathology | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 13 Original policy |