Regence BlueCross BlueShield of Utah prior authorization, page 36

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
Code	Description	Source
28122	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28124	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28126	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28192	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28200	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28208	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28232	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28238	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28250	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28272	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28285	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28289	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28291	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28292	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28295	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28296	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28297	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28298	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28299	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28300	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28306	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28308	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28315	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28322	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28415	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28445	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28465	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28485	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28505	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28525	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28615	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28645	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28666	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28715	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28725	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28740	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28750	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28755	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28810	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
28825	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29834	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29835	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29838	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29846	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29848	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29900	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
29901	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
30115	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
30117	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
30130	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy

Sources

Commercial Pre-authorization List