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Peach State Health Plan prior authorization code reference, page 101

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Source code lookup

Each row links an imported source code to its service or category label. Check the original document for the complete plan scope, review type and qualifications.

Source code index

Imported source codes and labels; verify the complete review requirements in the original document
CodeDescriptionSource
30462Plastic procedures on nose (Rhinoplasty)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
30465Plastic procedures on nose (Rhinoplasty)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0356TPulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0781TPulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0782TPulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
94005Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
94625Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
94626Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
94799Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
C8005Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
G0237Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
G0238Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
G0239Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
G0424Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
S9473Pulmonary Function Tests (PFTs) & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0725THearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0726THearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0727THearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0728THearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
0729THearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
92507Hearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
92508Hearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
92526Hearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
92609Hearing and Speech EvaluationsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5011Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5014Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5040Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5050Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5060Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5090Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5171Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5172Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5181Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5211Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5212Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5213Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5214Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5215Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5221Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5242Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5244Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5245Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5246Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5247Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5254Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5255Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5256Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5257Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5258Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy
V5259Hearing devices and audiology suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 18 Original policy

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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