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: The code check tool doesn't include non-specific or unlisted codes (general codes that don't describe specific services) unless they're associated with clinical review criteria. These codes are reviewed when claims are submitted.

    This tool isn't a guarantee of coverage as 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.

    Learn more