Peach State Health Plan prior authorization, page 81

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

Prior authorization codes
CodeDescriptionSource
J7193Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7194Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7195Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7196Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7197Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7198Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7199Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7200Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7201Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7203Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7205Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7208Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7210Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7211Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7212Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7213Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7214Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7311Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7312Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7313Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7314Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7315Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7318Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7321Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7323Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7324Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7325Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7326Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7327Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7328Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7329Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7331Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7332Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7351Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7352Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7353Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7355Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7356Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7401Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7402Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7504Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7511Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7514Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7515Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7516Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7517Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7518Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7519Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7521Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy
J7525Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 15 Original policy

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.