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
Exploration of orbit (transcranial approach); with removal of lesion
Service Code
61333 (CPT) Exploration of orbit (transcranial approach); with removal of lesion
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)
Service Code
61340 (CPT) Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation)
Service Code
61343 (CPT) Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Other cranial decompression, posterior fossa
Service Code
61345 (CPT) Other cranial decompression, posterior fossa
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion
Service Code
61450 (CPT) Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, suboccipital; for exploration or decompression of cranial nerves
Service Code
61458 (CPT) Craniectomy, suboccipital; for exploration or decompression of cranial nerves
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, suboccipital; for section of 1 or more cranial nerves
Service Code
61460 (CPT) Craniectomy, suboccipital; for section of 1 or more cranial nerves
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy; with excision of tumor or other bone lesion of skull
Service Code
61500 (CPT) Craniectomy; with excision of tumor or other bone lesion of skull
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy; for osteomyelitis
Service Code
61501 (CPT) Craniectomy; for osteomyelitis
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma
Service Code
61510 (CPT) Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial
Service Code
61512 (CPT) Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial
Service Code
61514 (CPT) Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial
Service Code
61516 (CPT) Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure)
Service Code
61517 (CPT) Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull
Service Code
61518 (CPT) Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma
Service Code
61519 (CPT) Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor
Service Code
61520 (CPT) Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull
Service Code
61521 (CPT) Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, infratentorial or posterior fossa; for excision of brain abscess
Service Code
61522 (CPT) Craniectomy, infratentorial or posterior fossa; for excision of brain abscess
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst
Service Code
61524 (CPT) Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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