PA Lookup
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12465 Results
Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)
Service Code
31051 (CPT) Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; external, simple (trephine operation)
Service Code
31070 (CPT) Sinusotomy frontal; external, simple (trephine operation)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch type)
Service Code
31075 (CPT) Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch type)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)
Service Code
31080 (CPT) Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)
Service Code
31081 (CPT) Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision
Service Code
31084 (CPT) Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision
Service Code
31085 (CPT) Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision
Service Code
31086 (CPT) Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision
Service Code
31087 (CPT) Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)
Service Code
31090 (CPT) Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ethmoidectomy; intranasal, anterior
Service Code
31200 (CPT) Ethmoidectomy; intranasal, anterior
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ethmoidectomy; intranasal, total
Service Code
31201 (CPT) Ethmoidectomy; intranasal, total
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ethmoidectomy; extranasal, total
Service Code
31205 (CPT) Ethmoidectomy; extranasal, total
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Maxillectomy; without orbital exenteration
Service Code
31225 (CPT) Maxillectomy; without orbital exenteration
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Maxillectomy; with orbital exenteration (en bloc)
Service Code
31230 (CPT) Maxillectomy; with orbital exenteration (en bloc)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
Service Code
31231 (CPT) Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)
Service Code
31233 (CPT) Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)
Service Code
31235 (CPT) Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
Service Code
31237 (CPT) Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage
Service Code
31238 (CPT) Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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