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
Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;
Service Code
61526 (CPT) Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy
Service Code
61530 (CPT) Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring
Service Code
61531 (CPT) Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring
Service Code
61533 (CPT) Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery
Service Code
61534 (CPT) Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)
Service Code
61535 (CPT) Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)
Service Code
61536 (CPT) Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery
Service Code
61537 (CPT) Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery
Service Code
61538 (CPT) Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery
Service Code
61539 (CPT) Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery
Service Code
61540 (CPT) Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for transection of corpus callosum
Service Code
61541 (CPT) Craniotomy with elevation of bone flap; for transection of corpus callosum
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy
Service Code
61543 (CPT) Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus
Service Code
61544 (CPT) Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy with elevation of bone flap; for excision of craniopharyngioma
Service Code
61545 (CPT) Craniotomy with elevation of bone flap; for excision of craniopharyngioma
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach
Service Code
61546 (CPT) Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
Service Code
61548 (CPT) Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy for craniosynostosis; single cranial suture
Service Code
61550 (CPT) Craniectomy for craniosynostosis; single cranial suture
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniectomy for craniosynostosis; multiple cranial sutures
Service Code
61552 (CPT) Craniectomy for craniosynostosis; multiple cranial sutures
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Craniotomy for craniosynostosis; frontal or parietal bone flap
Service Code
61556 (CPT) Craniotomy for craniosynostosis; frontal or parietal bone flap
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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