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

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12465 Results

0983 Clinic

Service Code
0983 (Revenue) 0983 Clinic
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0984 Medical social services

Service Code
0984 (Revenue) 0984 Medical social services
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0985 EKG

Service Code
0985 (Revenue) 0985 EKG
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0986 EEG

Service Code
0986 (Revenue) 0986 EEG
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0987 Hospital visit

Service Code
0987 (Revenue) 0987 Hospital visit
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0988 Consultation

Service Code
0988 (Revenue) 0988 Consultation
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0989 Private duty nurse

Service Code
0989 (Revenue) 0989 Private duty nurse
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0990 General

Service Code
0990 (Revenue) 0990 General
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0991 Cafeteria/guest tray

Service Code
0991 (Revenue) 0991 Cafeteria/guest tray
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0992 Private linen service

Service Code
0992 (Revenue) 0992 Private linen service
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0993 Telephone/telegraph

Service Code
0993 (Revenue) 0993 Telephone/telegraph
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0994 TV/radio

Service Code
0994 (Revenue) 0994 TV/radio
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0995 Nonpatient room rentals

Service Code
0995 (Revenue) 0995 Nonpatient room rentals
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0996 Late discharge charge

Service Code
0996 (Revenue) 0996 Late discharge charge
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0997 Admission kits

Service Code
0997 (Revenue) 0997 Admission kits
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0998 Beauty shop/barber

Service Code
0998 (Revenue) 0998 Beauty shop/barber
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

0999 Non covered ancillary services

Service Code
0999 (Revenue) 0999 Non covered ancillary services
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

BEHAVIORAL HEALTH ACCOMMODATIONS

Service Code
1005 (Revenue) BEHAVIORAL HEALTH ACCOMMODATIONS
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

Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest

Service Code
01112 (CPT) Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for procedures on bony pelvis

Service Code
01120 (CPT) Anesthesia for procedures on bony pelvis
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required