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Member and Recipient Service Line: 1-877-685-2415

Provider Support Service Line: 1-855-250-1539

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12465 Results

Diagnostic bone marrow; biopsy(ies)

Service Code
38221 (CPT) Diagnostic bone marrow; biopsy(ies)
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Diagnostic bone marrow; biopsy(ies) and aspiration(s)

Service Code
38222 (CPT) Diagnostic bone marrow; biopsy(ies) and aspiration(s)
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Bone marrow harvesting for transplantation; allogeneic

Service Code
38230 (CPT) Bone marrow harvesting for transplantation; allogeneic
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Bone marrow harvesting for transplantation; autologous

Service Code
38232 (CPT) Bone marrow harvesting for transplantation; autologous
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor

Service Code
38240 (CPT) Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Hematopoietic progenitor cell (HPC); autologous transplantation

Service Code
38241 (CPT) Hematopoietic progenitor cell (HPC); autologous transplantation
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Allogeneic lymphocyte infusions

Service Code
38242 (CPT) Allogeneic lymphocyte infusions
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Hematopoietic progenitor cell (HPC); HPC boost

Service Code
38243 (CPT) Hematopoietic progenitor cell (HPC); HPC boost
Prior Authorization Required
Yes
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Authorization Guidelines

See the Carolina Complete Health site for specific requirements

Reauthorization Guidelines

See the Carolina Complete Health site for specific requirements

How to Submit

Please submit your request to Carolina Complete Health

Drainage of lymph node abscess or lymphadenitis; simple

Service Code
38300 (CPT) Drainage of lymph node abscess or lymphadenitis; simple
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Drainage of lymph node abscess or lymphadenitis; extensive

Service Code
38305 (CPT) Drainage of lymph node abscess or lymphadenitis; extensive
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Lymphangiotomy or other operations on lymphatic channels

Service Code
38308 (CPT) Lymphangiotomy or other operations on lymphatic channels
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Suture and/or ligation of thoracic duct; cervical approach

Service Code
38380 (CPT) Suture and/or ligation of thoracic duct; cervical approach
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Suture and/or ligation of thoracic duct; thoracic approach

Service Code
38381 (CPT) Suture and/or ligation of thoracic duct; thoracic approach
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Suture and/or ligation of thoracic duct; abdominal approach

Service Code
38382 (CPT) Suture and/or ligation of thoracic duct; abdominal approach
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Biopsy or excision of lymph node(s); open, superficial

Service Code
38500 (CPT) Biopsy or excision of lymph node(s); open, superficial
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)

Service Code
38505 (CPT) Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Biopsy or excision of lymph node(s); open, deep cervical node(s)

Service Code
38510 (CPT) Biopsy or excision of lymph node(s); open, deep cervical node(s)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad

Service Code
38520 (CPT) Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Biopsy or excision of lymph node(s); open, deep axillary node(s)

Service Code
38525 (CPT) Biopsy or excision of lymph node(s); open, deep axillary node(s)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Biopsy or excision of lymph node(s); open, internal mammary node(s)

Service Code
38530 (CPT) Biopsy or excision of lymph node(s); open, internal mammary node(s)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required