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
12437 Results
Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Service Code
66250 (CPT) Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridotomy by stab incision (separate procedure); except transfixion
Service Code
66500 (CPT) Iridotomy by stab incision (separate procedure); except transfixion
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe
Service Code
66505 (CPT) Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridectomy, with corneoscleral or corneal section; for removal of lesion
Service Code
66600 (CPT) Iridectomy, with corneoscleral or corneal section; for removal of lesion
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridectomy, with corneoscleral or corneal section; with cyclectomy
Service Code
66605 (CPT) Iridectomy, with corneoscleral or corneal section; with cyclectomy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)
Service Code
66625 (CPT) Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)
Service Code
66630 (CPT) Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridectomy, with corneoscleral or corneal section; optical (separate procedure)
Service Code
66635 (CPT) Iridectomy, with corneoscleral or corneal section; optical (separate procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Repair of iris, ciliary body (as for iridodialysis)
Service Code
66680 (CPT) Repair of iris, ciliary body (as for iridodialysis)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture)
Service Code
66682 (CPT) Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ciliary body destruction; diathermy
Service Code
66700 (CPT) Ciliary body destruction; diathermy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ciliary body destruction; cyclophotocoagulation, transscleral
Service Code
66710 (CPT) Ciliary body destruction; cyclophotocoagulation, transscleral
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens
Service Code
66711 (CPT) Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ciliary body destruction; cryotherapy
Service Code
66720 (CPT) Ciliary body destruction; cryotherapy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Ciliary body destruction; cyclodialysis
Service Code
66740 (CPT) Ciliary body destruction; cyclodialysis
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)
Service Code
66761 (CPT) Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)
Service Code
66762 (CPT) Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)
Service Code
66770 (CPT) Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife)
Service Code
66820 (CPT) Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages)
Service Code
66821 (CPT) Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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