Regence BlueShield of Idaho prior authorization, page 32

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
13160	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
14020	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
14040	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
14060	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
15120	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
15240	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
17000	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
17110	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
17311	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
17313	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
19020	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
19101	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
19120	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
19125	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
20225	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
20240	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
20670	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
20680	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
20694	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
20912	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21011	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21012	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21014	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21029	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21030	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21031	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21040	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21046	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21315	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21320	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21330	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21335	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21336	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21337	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21356	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21550	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21552	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21554	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21555	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21556	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21930	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21931	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
21932	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
22901	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
22902	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
22903	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
23030	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
23071	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
23150	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy
23460	Surgical Site of Care - Hospital Outpatient	Commercial Pre-authorization List, Pg 1 Original policy

Sources

Commercial Pre-authorization List