The code check tool only shows codes used for non-individual plan members (group, association, etc.) and doesn't provider member-specific information. You'll also find this tool by signing in to Availity. Look for it in the Premera Payer Space in Resources or through Authorization & Referrals > Additional Authorizations and Referrals.
This tool doesn't support the following Premera plans:
Individual, Medicare Advantage, FEP, and some Shared Admin plans. View prior authorization information for those plans.
For pharmacy, view drugs requiring approval.
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.
Sign in to Availity to submit prior authorizations. View our prior authorization resources page for
more information on submitting prior authorization requests for Individual, out-of-area, Federal Employee Program (FEP), and Medicare Advantage plan members.
Note: Prior authorizations can't be submitted by phone.