Peach State Health Plan prior authorization, page 93
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 |
|---|---|---|
| V2530 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2599 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2600 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2610 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2615 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2623 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2625 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2627 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2630 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2631 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2632 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2700 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2702 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2710 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2715 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2718 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2730 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2744 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2745 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2750 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2755 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy |
| V2760 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2761 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2762 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2770 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2780 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2781 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2782 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2783 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2784 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2785 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2786 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2790 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2797 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| V2799 | Visual aids and other optical supplies | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0335T | Foot & Ankle Surgery | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 28890 | Foot & Ankle Surgery | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 28899 | Foot & Ankle Surgery | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0101T | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0102T | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0707T | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0869T | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 20974 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 20975 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 20979 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 20999 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 21089 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 21120 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 21121 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 21122 | General Orthopedics, Trauma, & Fracture Treatment | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |