Regence BlueCross BlueShield of Oregon prior authorization, page 12
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 |
|---|---|---|
| 61798 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 61799 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 61800 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 63620 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 63621 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77301 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77338 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77371 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77372 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77373 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77432 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77435 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77520 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77522 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77523 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 77525 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| G0339 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| G0340 | Charged-Particle (Proton) Radiotherapy | Commercial Pre-authorization List, Pg 1 Original policy |
| 43206 | Confocal Laser Endomicroscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| 43252 | Confocal Laser Endomicroscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| 88375 | Confocal Laser Endomicroscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| 98978 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| A9291 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| A9292 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| A9294 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| E1905 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| G0552 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| G0553 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| G0554 | Digital Therapeutic Products | Commercial Pre-authorization List, Pg 1 Original policy |
| 31626 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| 31627 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| C7509 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| C7510 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| C7511 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| C7567 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| C8005 | Electromagnetic Navigation Bronchoscopy | Commercial Pre-authorization List, Pg 1 Original policy |
| 11920 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 11921 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15769 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15771 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15772 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15773 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15774 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15775 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15776 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15825 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15828 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15829 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 15839 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |
| 17380 | Gender Affirming Interventions for Gender Dysphoria | Commercial Pre-authorization List, Pg 1 Original policy |