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
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm
Service Code
11443 (CPT) Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm
Service Code
11444 (CPT) Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm
Service Code
11446 (CPT) Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair
Service Code
11450 (CPT) Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair
Service Code
11451 (CPT) Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair
Service Code
11462 (CPT) Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair
Service Code
11463 (CPT) Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair
Service Code
11470 (CPT) Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair
Service Code
11471 (CPT) Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less
Service Code
11600 (CPT) Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm
Service Code
11601 (CPT) Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm
Service Code
11602 (CPT) Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm
Service Code
11603 (CPT) Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm
Service Code
11604 (CPT) Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm
Service Code
11606 (CPT) Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
Service Code
11620 (CPT) Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
Service Code
11621 (CPT) Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm
Service Code
11622 (CPT) Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm
Service Code
11623 (CPT) Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm
Service Code
11624 (CPT) Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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