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
Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones
Service Code
01820 (CPT) Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for diagnostic arthroscopic procedures on the wrist
Service Code
01829 (CPT) Anesthesia for diagnostic arthroscopic procedures on the wrist
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified
Service Code
01830 (CPT) Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; 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 open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement
Service Code
01832 (CPT) Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified
Service Code
01840 (CPT) Anesthesia for procedures on arteries of forearm, wrist, and hand; 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 procedures on arteries of forearm, wrist, and hand; embolectomy
Service Code
01842 (CPT) Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)
Service Code
01844 (CPT) Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified
Service Code
01850 (CPT) Anesthesia for procedures on veins of forearm, wrist, and hand; 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 procedures on veins of forearm, wrist, and hand; phleborrhaphy
Service Code
01852 (CPT) Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for forearm, wrist, or hand cast application, removal, or repair
Service Code
01860 (CPT) Anesthesia for forearm, wrist, or hand cast application, removal, or repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for diagnostic arteriography/venography
Service Code
01916 (CPT) Anesthesia for diagnostic arteriography/venography
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include Swan-Ganz catheter)
Service Code
01920 (CPT) Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include Swan-Ganz catheter)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for non-invasive imaging or radiation therapy
Service Code
01922 (CPT) Anesthesia for non-invasive imaging or radiation therapy
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified
Service Code
01924 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the arterial system; 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 therapeutic interventional radiological procedures involving the arterial system; carotid or coronary
Service Code
01925 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic
Service Code
01926 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified
Service Code
01930 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); 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 therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [TIPS])
Service Code
01931 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [TIPS])
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular
Service Code
01932 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial
Service Code
01933 (CPT) Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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