Code Check Tool for Non-Individual Plan Members

  • The code check tool only shows codes used for non-individual plan members (group, association, etc.) and doesn't accept modifiers.

    Enter a 5-character code (CPT, ADA, or HCPCS)

    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.

    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