The code check tool only shows codes used for non-individual plan members (group, association, etc.) and doesn't accept modifiers.
1. Enter a 5-character code (CPT, ADA, or HCPCS)
This tool doesn't accept modifiers.
Note: We review all non-specific and unlisted
codes for medical necessity, even if they don't specifically relate to a
medical policy. The code check tool isn't a guarantee of coverage since member
contracts may differ in benefits.
2. Submit a prior authorization request
View our prior authorization page to get further information on submitting prior authorization requests for non-individual, individual, out-of-area, Federal Employee Program (FEP), and Medicare plan members.
Note: Prior authorizations can't be submitted by phone.
Learn more