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
Glucagon tolerance test
Service Code
82946 (CPT) Glucagon tolerance test
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose; quantitative, blood (except reagent strip)
Service Code
82947 (CPT) Glucose; quantitative, blood (except reagent strip)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose; blood, reagent strip
Service Code
82948 (CPT) Glucose; blood, reagent strip
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose; post glucose dose (includes glucose)
Service Code
82950 (CPT) Glucose; post glucose dose (includes glucose)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose; tolerance test (GTT), 3 specimens (includes glucose)
Service Code
82951 (CPT) Glucose; tolerance test (GTT), 3 specimens (includes glucose)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure)
Service Code
82952 (CPT) Glucose; tolerance test, each additional beyond 3 specimens (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
Glucose-6-phosphate dehydrogenase (G6PD); quantitative
Service Code
82955 (CPT) Glucose-6-phosphate dehydrogenase (G6PD); quantitative
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose-6-phosphate dehydrogenase (G6PD); screen
Service Code
82960 (CPT) Glucose-6-phosphate dehydrogenase (G6PD); screen
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use
Service Code
82962 (CPT) Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glucosidase, beta
Service Code
82963 (CPT) Glucosidase, beta
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glutamate dehydrogenase
Service Code
82965 (CPT) Glutamate dehydrogenase
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glutamyltransferase, gamma (GGT)
Service Code
82977 (CPT) Glutamyltransferase, gamma (GGT)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glutathione
Service Code
82978 (CPT) Glutathione
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glutathione reductase, RBC
Service Code
82979 (CPT) Glutathione reductase, RBC
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Glycated protein
Service Code
82985 (CPT) Glycated protein
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Gonadotropin; follicle stimulating hormone (FSH)
Service Code
83001 (CPT) Gonadotropin; follicle stimulating hormone (FSH)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Gonadotropin; luteinizing hormone (LH)
Service Code
83002 (CPT) Gonadotropin; luteinizing hormone (LH)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Growth hormone, human (HGH) (somatotropin)
Service Code
83003 (CPT) Growth hormone, human (HGH) (somatotropin)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1)
Service Code
83006 (CPT) Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13)
Service Code
83009 (CPT) Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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