PA Lookup
If you have questions about prior authorizations, please call:
Member and Recipient Service Line: 1-877-685-2415
Provider Support Service Line: 1-855-250-1539
12465 Results
Revision of tracheostomy scar
Service Code
31830 (CPT) Revision of tracheostomy scar
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Unlisted procedure, trachea, bronchi
Service Code
31899 (CPT) Unlisted procedure, trachea, bronchi
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
Authorization Guidelines
Please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.
How to Submit
Please submit your request to Trillium Health Resources
Thoracostomy; with rib resection for empyema
Service Code
32035 (CPT) Thoracostomy; with rib resection for empyema
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracostomy; with open flap drainage for empyema
Service Code
32036 (CPT) Thoracostomy; with open flap drainage for empyema
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral
Service Code
32096 (CPT) Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral
Service Code
32097 (CPT) Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy, with biopsy(ies) of pleura
Service Code
32098 (CPT) Thoracotomy, with biopsy(ies) of pleura
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with exploration
Service Code
32100 (CPT) Thoracotomy; with exploration
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear
Service Code
32110 (CPT) Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; for postoperative complications
Service Code
32120 (CPT) Thoracotomy; for postoperative complications
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with open intrapleural pneumonolysis
Service Code
32124 (CPT) Thoracotomy; with open intrapleural pneumonolysis
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with cyst(s) removal, includes pleural procedure when performed
Service Code
32140 (CPT) Thoracotomy; with cyst(s) removal, includes pleural procedure when performed
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed
Service Code
32141 (CPT) Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with removal of intrapleural foreign body or fibrin deposit
Service Code
32150 (CPT) Thoracotomy; with removal of intrapleural foreign body or fibrin deposit
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with removal of intrapulmonary foreign body
Service Code
32151 (CPT) Thoracotomy; with removal of intrapulmonary foreign body
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Thoracotomy; with cardiac massage
Service Code
32160 (CPT) Thoracotomy; with cardiac massage
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Pneumonostomy, with open drainage of abscess or cyst
Service Code
32200 (CPT) Pneumonostomy, with open drainage of abscess or cyst
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Pleural scarification for repeat pneumothorax
Service Code
32215 (CPT) Pleural scarification for repeat pneumothorax
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Decortication, pulmonary (separate procedure); total
Service Code
32220 (CPT) Decortication, pulmonary (separate procedure); total
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Decortication, pulmonary (separate procedure); partial
Service Code
32225 (CPT) Decortication, pulmonary (separate procedure); partial
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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