Peach State Health Plan prior authorization, page 98
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 |
|---|---|---|
| 29886 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29887 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29888 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29889 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29891 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29892 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29893 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29894 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29895 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29898 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29899 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29914 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29915 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29916 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29999 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| C8003 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| G0289 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| S2118 | Major Joint Reconstruction & Arthroscopy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 29799 | Orthopedic Supplies, Casting, & Wound Care | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0202T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0219T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0220T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0221T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0222T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0274T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0275T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0375T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0656T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0657T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0790T | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22533 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22548 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22551 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22552 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22554 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22558 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22590 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22595 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22600 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22612 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22614 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22630 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22633 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22830 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22836 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22837 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22838 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22847 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 22849 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63001 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |