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Regence BlueCross BlueShield of Utah prior authorization, page 4

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
E0616Carelon cardiovascularCommercial Pre-authorization List, Pg 1 Original policy
G0448Carelon cardiovascularCommercial Pre-authorization List, Pg 1 Original policy
90935Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90937Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90945Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90947Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90951Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90952Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90953Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90954Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90955Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90956Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90957Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90989Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
90993Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
G0308Dialysis treatmentCommercial Pre-authorization List, Pg 1 Original policy
E2500Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2502Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2504Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2506Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2508Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2510Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2511Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E2512Augmentative Communication Devices and SystemsCommercial Pre-authorization List, Pg 1 Original policy
E0747Bone Growth Stimulators, Electrical (Osteogenic Stimulation)Commercial Pre-authorization List, Pg 1 Original policy
E0748Bone Growth Stimulators, Electrical (Osteogenic Stimulation)Commercial Pre-authorization List, Pg 1 Original policy
E0749Bone Growth Stimulators, Electrical (Osteogenic Stimulation)Commercial Pre-authorization List, Pg 1 Original policy
E0760Ultrasonic Bone Growth Stimulators (Osteogenic Stimulation)Commercial Pre-authorization List, Pg 1 Original policy
20979Ultrasonic Bone Growth Stimulators (Osteogenic Stimulation)Commercial Pre-authorization List, Pg 1 Original policy
L5010Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5020Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5050Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5060Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5100Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5105Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5150Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5160Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5200Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5210Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5220Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5230Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5250Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5270Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5280Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5301Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5312Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5321Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5331Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5341Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 Original policy
L5610Definitive Lower Limb ProsthesesCommercial Pre-authorization List, Pg 1 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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