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Peach State Health Plan prior authorization, page 96

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
25441General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
25442General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
25443General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
25444General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
25445General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
25446General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
25999General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
26989General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27096General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27125General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27140General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27146General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27147General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27151General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27156General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27158General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27161General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27170General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27278General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27279General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27403General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27405General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27407General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27409General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27412General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27415General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27416General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27418General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27420General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27422General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27424General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27425General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27427General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27428General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27429General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27438General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27570General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27599General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27702General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
27899General Orthopedics, Trauma, & Fracture TreatmentCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23405Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23410Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23412Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23415Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23420Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23430Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23450Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23455Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23460Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy
23462Major Joint Reconstruction & ArthroscopyCMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 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.

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