Code Check Tool

  • To see if prior authorization or pre-service review is required, log in to our prior authorization tool for member-specific information. For general code information, use our code check tool.

    You can enter a medical or dental service code.

    1. Check a code

    Note: This tool does not include non-specific or unlisted codes (general codes that do not describe specific services) unless they are associated with a specific medical policy. We review all non-specific and unlisted codes when the claim is submitted, regardless of whether they relate to a medical policy. The code check tool is not a guarantee of coverage as member contracts may differ in benefits.

    The Federal Employee Program (FEP) has a separate code list and review requirements. View FEP prior authorization details.

    Please make sure you're entering a valid, 5-character code. The code check tool does not accept modifiers.

    2. Submit a review

    Premera providers
    Submit a request using our prior authorization tool. Learn more about submitting prior authorization, check out the code list, or view our tool guide for helpful tips.

    Providers outside of Washington and Alaska
    Log in to your local Blue plan’s website for tools for out-of-area members. You’ll be routed to our prior auth tool to submit a request and attach records. You can also use our pre-service review request form or view our medical policies for coverage criteria.

    For the best online experience with AIM and eviCore, start by logging in to the Blue plan’s website in your service area to find tools for out-of-area members. You’ll be routed to their website where you can submit authorizations for Premera members.

    Dental providers:
    Please submit dental pre-determination requests as you would normally submit a claim, by electronic data interchange (EDI), or by mail to:

    Dental Review
    P.O. Box 91059
    Seattle, WA 98111-9159