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
0719 Other recovery room
Service Code
0719 (Revenue) 0719 Other recovery room
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0720 General
Service Code
0720 (Revenue) 0720 General
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0721 Labor
Service Code
0721 (Revenue) 0721 Labor
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0722 Delivery
Service Code
0722 (Revenue) 0722 Delivery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0723 Circumcision
Service Code
0723 (Revenue) 0723 Circumcision
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0724 Birthing center
Service Code
0724 (Revenue) 0724 Birthing center
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0729 Other labor room/delivery
Service Code
0729 (Revenue) 0729 Other labor room/delivery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for procedures on upper posterior abdominal wall
Service Code
00730 (CPT) Anesthesia for procedures on upper posterior abdominal wall
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified
Service Code
00731 (CPT) Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP)
Service Code
00732 (CPT) Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0739 Other EKG/ECG
Service Code
0739 (Revenue) 0739 Other EKG/ECG
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0740 General - EEG
Service Code
0740 (Revenue) 0740 General - EEG
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0749 Other EEG
Service Code
0749 (Revenue) 0749 Other EEG
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for hernia repairs in upper abdomen; not otherwise specified
Service Code
00750 (CPT) Anesthesia for hernia repairs in upper abdomen; not otherwise specified
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence
Service Code
00752 (CPT) Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for hernia repairs in upper abdomen; omphalocele
Service Code
00754 (CPT) Anesthesia for hernia repairs in upper abdomen; omphalocele
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia
Service Code
00756 (CPT) Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0759 Other gastrointestinal
Service Code
0759 (Revenue) 0759 Other gastrointestinal
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0760 General - Observation Room
Service Code
0760 (Revenue) 0760 General - Observation Room
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
0761 Treatment room
Service Code
0761 (Revenue) 0761 Treatment room
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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