Peach State Health Plan prior authorization, page 99
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 |
|---|---|---|
| 63003 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63005 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63011 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63012 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63015 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63016 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63017 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63020 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63030 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63040 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63042 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63045 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63046 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63047 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63050 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63051 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63055 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63056 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63064 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63066 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63075 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63077 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63078 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63085 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63086 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63185 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63190 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 63191 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| C9757 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| G0276 | Spine Surgery (Fusion, Laminectomy, & Deformity) | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 98929 | Chiropractic Services | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0278T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0693T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0733T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0734T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0770T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0771T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0772T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0773T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0774T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 0778T | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97110 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97112 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97113 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97116 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97124 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97127 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97140 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97530 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |
| 97533 | PT/OT/Speech therapy | CMS Final Rule 0057-F Prior Authorization Requirements, Pg 17 Original policy |