Regence BlueCross BlueShield of Utah prior authorization, page 43
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 |
|---|---|---|
| 69424 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69436 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69450 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69505 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69602 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69610 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69620 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69631 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69632 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69633 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69642 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69643 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69644 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69646 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69666 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 69801 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 58263 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 58661 | Surgical Site of Care - Hospital Outpatient | Commercial Pre-authorization List, Pg 1 Original policy |
| 32664 | Surgical Treatments for Hyperhidrosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 64818 | Surgical Treatments for Hyperhidrosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 69676 | Surgical Treatments for Hyperhidrosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 15832 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15833 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15834 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15835 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15836 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15837 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15838 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15876 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15877 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15878 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 15879 | Surgical Treatment for Lymphedema and Lipedema | Commercial Pre-authorization List, Pg 1 Original policy |
| 21199 | Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance | Commercial Pre-authorization List, Pg 1 Original policy |
| 21685 | Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance | Commercial Pre-authorization List, Pg 1 Original policy |
| 41120 | Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance | Commercial Pre-authorization List, Pg 1 Original policy |
| 42140 | Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance | Commercial Pre-authorization List, Pg 1 Original policy |
| 42145 | Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance | Commercial Pre-authorization List, Pg 1 Original policy |
| 42160 | Surgeries for Snoring, Obstructive Sleep Apnea Syndrome, and Upper Airway Resistance | Commercial Pre-authorization List, Pg 1 Original policy |
| 21010 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 21050 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 29800 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 29804 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 21240 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 21242 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 21243 | Temporomandibular Joint (TMJ) Surgical Interventions | Commercial Pre-authorization List, Pg 1 Original policy |
| 33361 | Transcatheter Aortic-Valve Implantation for Aortic Stenosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 33362 | Transcatheter Aortic-Valve Implantation for Aortic Stenosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 33363 | Transcatheter Aortic-Valve Implantation for Aortic Stenosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 33364 | Transcatheter Aortic-Valve Implantation for Aortic Stenosis | Commercial Pre-authorization List, Pg 1 Original policy |
| 33365 | Transcatheter Aortic-Valve Implantation for Aortic Stenosis | Commercial Pre-authorization List, Pg 1 Original policy |