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
Special stain including interpretation and report; Group III, for enzyme constituents
Service Code
88319 (CPT) Special stain including interpretation and report; Group III, for enzyme constituents
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Consultation and report on referred slides prepared elsewhere
Service Code
88321 (CPT) Consultation and report on referred slides prepared elsewhere
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Consultation and report on referred material requiring preparation of slides
Service Code
88323 (CPT) Consultation and report on referred material requiring preparation of slides
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Consultation, comprehensive, with review of records and specimens, with report on referred material
Service Code
88325 (CPT) Consultation, comprehensive, with review of records and specimens, with report on referred material
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Pathology consultation during surgery;
Service Code
88329 (CPT) Pathology consultation during surgery;
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen
Service Code
88331 (CPT) Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure)
Service Code
88332 (CPT) Pathology consultation during surgery; each additional tissue block with frozen section(s) (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
Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site
Service Code
88333 (CPT) Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure)
Service Code
88334 (CPT) Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (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
Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)
Service Code
88341 (CPT) Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (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
Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure
Service Code
88342 (CPT) Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure
Service Code
88344 (CPT) Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Immunofluorescence, per specimen; initial single antibody stain procedure
Service Code
88346 (CPT) Immunofluorescence, per specimen; initial single antibody stain procedure
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Electron microscopy, diagnostic
Service Code
88348 (CPT) Electron microscopy, diagnostic
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)
Service Code
88350 (CPT) Immunofluorescence, per specimen; each additional single antibody stain procedure (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
Morphometric analysis; skeletal muscle
Service Code
88355 (CPT) Morphometric analysis; skeletal muscle
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Morphometric analysis; nerve
Service Code
88356 (CPT) Morphometric analysis; nerve
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Morphometric analysis; tumor (eg, DNA ploidy)
Service Code
88358 (CPT) Morphometric analysis; tumor (eg, DNA ploidy)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual
Service Code
88360 (CPT) Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology
Service Code
88361 (CPT) Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health
How to Submit
N/A - No authorization is required
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