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Peach State Health Plan prior authorization code reference, page 90

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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
92284General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92285General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92286General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92287General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
G0117General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
G0118General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
S0620General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
S0621General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
S3000General Eye Exams & DiagnosticsCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
0100TGlaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
0660TGlaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
0661TGlaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
0671TGlaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
0730TGlaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
0810TGlaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65710Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65730Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65750Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65755Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65756Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65767Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65771Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65780Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65781Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
65782Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
67299Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
67399Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
67599Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
68399Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
68841Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
68899Glaucoma & Eyeball ProceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
66989Lens and cataract proceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
66991Lens and cataract proceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
66999Lens and cataract proceduresCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92310Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92311Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92312Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92313Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92314Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92315Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92316Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92317Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92325Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92326Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92340Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92341Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92342Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92352Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92353Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 Original policy
92354Visual aids and other optical suppliesCMS Final Rule 0057-F Prior Authorization Requirements, Pg 16 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.

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