1Carrier A2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin90.8925.04240NANA2Carrier A2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu60384NANA3Carrier A2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9279Monitoring feature/deviceNOC10432NANA4Carrier A2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin90.8925.04NANA5Carrier A2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu60NANA6Carrier A2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9279Monitoring feature/deviceNOC10NANA7Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINUOUS GLUCOSE MONITOR SYSTEM30139.0792.80.46NANA8Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM131092.340NANA9Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINUOUS GLUCOSE MONITOR710.9664.6390.110.46NANA10Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINUOUS GLUCOSE MONITOR SYSTEM210.95084.420NANA11Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN130.920114.750NANA12Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINUOUS GLUCOSE MONITOR RECEIVER/MONITOR100193.680NANA13Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553CONTINUOUS GLUCOSE MONITOR SYSTEM SUPPLIES100193.680NANA14Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINUOUS GLUCOSE MONITOR SYSTEM30139.0792.80.46NANA15Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM131092.340NANA16Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINUOUS GLUCOSE MONITOR710.9664.6390.110.46NANA17Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINUOUS GLUCOSE MONITOR SYSTEM210.95084.420NANA18Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN130.920114.750NANA19Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINUOUS GLUCOSE MONITOR RECEIVER/MONITOR100193.680NANA20Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553CONTINUOUS GLUCOSE MONITOR SYSTEM SUPPLIES100193.680NANA21Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT95249GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING111188.2NANA22Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS810.375.4NANA23Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE4490.996.7199.1NANA24Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXT AMB INSULIN DELIVERY620.9810.5270.1NANA25Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4456ADHESIVE REMOVER, WIPES, ANY TYPE, EACH110.917.2368.8NANA26Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT95250GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL290.8616.1429.4NANA27Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D10410.8514.7371.7NANA28Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0607HOME BLOOD GLUCOSE MONITOR100.87.3193.9NANA29Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1790.7863.9385.1NANA30Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES210.6734.3956.6NANA31Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95249GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING111188.2NANA32Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS810.375.4NANA33Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA6460SYNTHETIC DRSG <= 16 SQ I210.1NANA34Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH21382.5NANA35Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4245ALCOHOL WIPES PER BOX110.2NANA36Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA6461SYNTHETIC DRSG >16<=48 SQ110.1NANA37Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9278RECEIVER MON; EXT INTERSTITIAL CONT GLU MON SYS111.5NANA38Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4340INDWELLING CATH SPECIAL110.1NANA39Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5120SKIN BARRIER, WIPE OR SWA11191.6NANA40Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4352COUDE TIP URINARY CATH114.4NANA41Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0781INFUS PUMP AMBULATORY1011013NANA42Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERN AMBUL INSULIN INFUS PUMP17900.0263.9385.1NANA43Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D104100.0114.7371.7NANA44Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS INSULIN PUMP NON NE7416.2197.2NANA45Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXT AMB INSULIN DELIVERY1719.8517.4NANA46Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS7142.7594.1NANA47Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES190.7919.92064.6NANA48Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D4690.7513.1554.1NANA49Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP860.6933.7474.1NANA50Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4456ADHESIVE REMOVER, WIPES, ANY TYPE, EACH30.67199.1NANA51Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ4186EPIFIX, PER SQ CM40.560.1258.8NANA52Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4253BLOOD GLUCOSE/REAGENT STR20.51.2NANA53Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA6209FOAM DRSG <=16 SQ IN W/O201.2NANA54Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS INSULIN PUMP NON NE7416.2197.2NANA55Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXT AMB INSULIN DELIVERY1719.8517.4NANA56Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS7142.7594.1NANA57Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ4110PRIMATRIX PER SQ CM113.3NANA58Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES190.7919.92064.6NANA59Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D4690.7513.1554.1NANA60Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP860.6933.7474.1NANA61Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4456ADHESIVE REMOVER, WIPES, ANY TYPE, EACH30.67199.1NANA62Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ4186EPIFIX, PER SQ CM40.560.1258.8NANA63Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4253BLOOD GLUCOSE/REAGENT STR20.51.2NANA64Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0781EXTERNAL AMBULATORY INFUS200.526.21429.8NANA65Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D46900.0113.1554.10NANA66Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERN AMBUL INSULIN INFUS PUMP8600.0133.7474.10NANA67Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE49118.8NANA68Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL4813.422.6NANA69Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC28116.4NANA70Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D415.2NANA71Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA6257TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS3111.2NANA72Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1320.933.9NANA73Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN220.8641.1NANA74Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor320.38NANA75Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH30.3365NANA76Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE49118.8NANA77Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL4813.422.6NANA78Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC28116.4NANA79Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D415.2NANA80Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6257TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS3111.2NANA81Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1320.933.9NANA82Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN220.8641.1NANA83Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor320.38NANA84Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH30.3365NANA85Carrier F2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAtest strips140.846.5745.22NANA86Carrier F2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAtest strips140.846.5745.22NANA87Carrier F2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAtest strips14006.5745.22NANA88Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.899.5NANA89Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ4186EPIFIX PER SQ CM1124NANA90Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE100.813.231.7NANA91Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D290.797.937.9NANA92Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC90.7838.5NANA93Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS130.7712.222NANA94Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOW FOR TX CGM1 MO SPL Equal to 1 U OF SERVICE30.67NANA95Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4253BLD GLU TEST/REAGT STRIPS HOME BLD GLU MON-5020.5NANA96Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP AND SPL SHOE MX DNSITY INSRT1046.5NANA97Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499UNLISTED EVALUATION AND MANAGEMENT SERVICE1069.1NANA98Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.895.5NANA99Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA1156.9NANA100Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5514DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA1176.5NANA101Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ4186EPIFIX PER SQ CM1124NANA102Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95249CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT1118.5NANA103Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE100.814.835.4NANA104Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D290.798.529.2NANA105Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC90.7814.838.5NANA106Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS130.7712.222NANA107Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOW FOR TX CGM1 MO SPL Equal to 1 U OF SERVICE30.671.7213.8NANA108Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC900.1114.838.5NANA109Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE1000.114.835.4NANA110Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS1300.0812.222NANA111Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN1300.0814.895.5NANA112Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D2900.038.529.2NANA113Carrier H2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAtest strips2180.846.518.17NANA114Carrier H2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAtest strips2180.846.518.17NANA115Carrier H2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAtest strips218006.58.17NANA116Carrier I2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin8120.44360NANA117Carrier I2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin8120.440.2NANA118Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin950.9949.14NANA119Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu10NANA120Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10125.98NANA121Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10125.98NANA122Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin950.9949.14NANA123Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu1011.1NANA124Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10125.9828.7NANA125Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10125.98NANA126Carrier K2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN3115.657.55NANA127Carrier K2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN3115.657.55NANA128Carrier K2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN30115.657.55NANA129Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN7116.640.26NANA130Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA3147.4NANA131Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0607HOME BLOOD GLUCOSE MONITOR1195.5NANA132Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D30.6771.31NANA133Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS30.6771.31NANA134Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9278RECEIVER MON; EXT INTERSTITIAL CONT GLU MON SYS30.6771.31NANA135Carrier L2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN7116.640.26NANA136Carrier L2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA3147.4NANA137Carrier L2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0607HOME BLOOD GLUCOSE MONITOR1195.5NANA138Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5301BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM21036NANA139Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5620S/A L5618,BELOW KNEE21036NANA140Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5637ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT21036NANA141Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5671ADDITION TO LOWER EXTREMITY, BELOW KNEE / ABOVE KNEE SUSPENSION LOCKING21036NANA142Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5673ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR PREFABRICATED, SOCKET INSERT, SILICONE GEL, ELASTOMERIC OR EQUAL, FOR USE WITH LOCKING MECHANISM21036NANA143Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5910ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM21036NANA144Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5940(TITANIUM, CARBON FIBER OR EQUAL) ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL21036NANA145Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5986EQUAL) ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT ("MCP" OR21036NANA146Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1007WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION20.51236NANA147Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2311POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXEDMOUNTING HARDWARE20.51236NANA148Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5301BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM2136NANA149Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620S/A L5618,BELOW KNEE2136NANA150Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT2136NANA151Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5671ADDITION TO LOWER EXTREMITY, BELOW KNEE / ABOVE KNEE SUSPENSION LOCKING2136NANA152Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5673ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR PREFABRICATED, SOCKET INSERT, SILICONE GEL, ELASTOMERIC OR EQUAL, FOR USE WITH LOCKING MECHANISM2136NANA153Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM2136NANA154Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5940(TITANIUM, CARBON FIBER OR EQUAL) ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL2136NANA155Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5986EQUAL) ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT ("MCP" OR2136NANA156Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5987ALL LOWER EXTREMITY PROSTHESIS, SHANK FOOT SYSTEM WITH VERTICAL LOADING PYLON.2136NANA157Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8420PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH2136NANA158Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER1119.4NANA159Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified1145.8NANA160Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2260.952.3NANA161Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate100.817.4496NANA162Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate50.85.4NANA163Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal90.5651.9NANA164Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine20.5121.5NANA165Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi100.2107.3NANA166Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0637Combination sit to stand system, any size, with seat lift feature, with or without wheels20112.7NANA167Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating1081.1NANA168Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0240Bath/shower chair, with or without wheels, any size10NANA169Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2213Pneumatic prop tire insert1081.1NANA170Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height1081.1NANA171Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA172Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware10NANA173Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2231Solid seat support base1081.1NANA174Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0445Oximeter Device For Measuring Blood Oxygen Levels Non-Invasively10NANA175Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device10NANA176Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2221Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each1081.1NANA177Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in1081.1NANA178Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in10NANA179Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0950Tray1081.1NANA180Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE8001Upright gait trainer10NANA181Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0956Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each10NANA182Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0957Wheelchair accessory, medial thigh support, prefabricated, including fixed mounting hardware, each10NANA183Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified1145.8NANA184Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER1119.4NANA185Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2260.952.3NANA186Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate100.817.4NANA187Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate50.85.4NANA188Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal90.5651.9NANA189Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine20.5121.5NANA190Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi100.2107.3NANA191Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0637Combination sit to stand system, any size, with seat lift feature, with or without wheels20112.7NANA192Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware10NANA193Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2221Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each1081.1NANA194Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height1081.1NANA195Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA196Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2231Solid seat support base1081.1NANA197Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating1081.1NANA198Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device10NANA199Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2213Pneumatic prop tire insert1081.1NANA200Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in1081.1NANA201Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0445Oximeter Device For Measuring Blood Oxygen Levels Non-Invasively10NANA202Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0240Bath/shower chair, with or without wheels, any size10NANA203Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in10NANA204Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0950Tray1081.1NANA205Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE8001Upright gait trainer10NANA206Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0956Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each10NANA207Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0957Wheelchair accessory, medial thigh support, prefabricated, including fixed mounting hardware, each10NANA208Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT2196NANA209Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR2124NANA210Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1002PWR SEAT TILT1172NANA211Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0748ELEC OSTEOGEN STIM SPINAL1148NANA212Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0856PWC GP3 STD SING POW OPT S/B1172NANA213Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE1148NANA214Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0747ELEC OSTEOGEN STIM NOT SPINE1048NANA215Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2300PWR SEAT ELEVATION SYS1072NANA216Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8699PROSTHETIC IMPLANT NOS1072NANA217Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT2196NANA218Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR2124NANA219Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1002PWR SEAT TILT1172NANA220Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0748ELEC OSTEOGEN STIM SPINAL1148NANA221Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0856PWC GP3 STD SING POW OPT S/B1172NANA222Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE1148NANA223Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0747ELEC OSTEOGEN STIM NOT SPINE1048NANA224Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2300PWR SEAT ELEVATION SYS1072NANA225Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8699PROSTHETIC IMPLANT NOS1072NANA226Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9004PARENTERAL NUTRITION INFUSION PUMP PORTABLE1410218.620NANA227Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM12126.1584.310NANA228Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE5140.9528.76129.910NANA229Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471RESPIRATORY DEVICE/BI-LEVEL PRESSURE CAPABILITY WITH BACKUP RATE FEATURE WITH NONINVASIVE INTERFACE200.9535.48111.490NANA230Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR/1 DELIVERY PORTABLE/CAPABLE OF DELIVERNG 85% OR>OXYGEN CONCENTRATION1540.9424.31191.520NANA231Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP SINGLE OR MULTIPLE CHANNELS WORN BY PATIENT960.9354.37125.180NANA232Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENTILATOR TYPE USED NON-INVASIVE INTERFACE140.9321.4108.130NANA233Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE310.870165.580NANA234Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470RESPIRATORY DEVICE/BI-LEVEL PRESSURE CAPABILITY WITHOUT BACKUP RATE FEATURE WITH NONINVASIVE INTERFACE210.810129.030NANA235Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE100.866.32144.160NANA236Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9004PARENTERAL NUTRITION INFUSION PUMP PORTABLE1410218.620NANA237Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM12126.1584.310NANA238Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0791PARENTERAL INFUSION PUMP STATIONARY SINGLE OR MULTICHANNEL710169.110NANA239Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0739REPAIR OR NONROUTINE SERVICE ON DURABLE MEDICAL EQUIPMENT OTHER THAN OXYGEN EQUIPMENT51044.180NANA240Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260HOSPITAL BED SEMI-ELECTRIC WITH ANY RAILS WITH MATTRESS510228.240NANA241Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760OSTEOGENESIS STIMULATOR-LOW INTENSITY ULTRASOUND NON-INVASIVE410136.650NANA242Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0483HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM, INCLUDES ALL ACCESSORIES AND SUPPLIES410211.550NANA243Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0003LIGHTWEIGHT WHEELCHAIR4128.0678.010NANA244Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0565COMPRESSOR AIR POWER SOURCE EQUIPMENT3129.03119.60NANA245Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108OTHER ACCESSORY31078.230NANA246Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE409611.7850.04NANA247Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE126313.2813.36NANA248Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH4510.995.48288.240NANA249Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT5450.988.52153.8NANA250Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT5170.985.24105.74NANA251Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7030CPAP FULL FACE MASK5160.980.8428.42NANA252Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR4750.981.83125.98NANA253Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 024620.983.84116.45NANA254Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL12800.9314.68164.9NANA255Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE31860.914.53162.26NANA256Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7031REPLACEMENT FACEMASK INTERFA416122.75816.21NANA257Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA36516.86596.81NANA258Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT94762NONINVASIVE EAR/PULSE OXIM O2 SAT CONT OVERNIGHT79112.3142.81NANA259Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7032CUSHN NASAL MASK INTERFACE REPLACEMENT ONLY EACH76152.87NANA260Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0445OXIMETER DEVICE FOR MEASURING BLOOD OXYGEN LEVELS, NON INVASIVE6413.5676.61NANA261Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9497HIT ANTIBIOTIC Q3H DIEM5616.9491.48NANA262Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1846KO W ADJ FLEX/EXT ROTAT MOLD5111.3484.28NANA263Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4361OSTOMY FACE PLATE48129.17.62NANA264Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0849TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE4711.2460.58NANA265Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0100CANES OF ANY MATERIAL4610.98267.66NANA266Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0483HIGH FREQ CHEST WALL OCSILLATION SYSTEM, INCL ALL ACCESSORIES/SUPPLIES, EA700.29227.380NANA267Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5701REPLACE SOCKET AB KNEE/KNEE600.17598.09NANA268Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2510SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH800.13759.750NANA269Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5301BK MOLD SOCKET SACH FT ENDO1700.06733.66NANA270Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4150ENTERAL FORMULAE CATEGORY I3900.0531.66641.68NANA271Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0691UV LIGHT THERAPY SYS, INCL BULBS/LAMPS/TIMER/EYE PROT; TX AREA 2 SQ FT OR <2600.0435.97234.88NANA272Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL1970AFO PLASTIC MOLDED W/ANKLE J4700.021.29242.97NANA273Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA6549GRADIENT COMPRESSION STOCKING/SLEEVE NOS12200.0116.43503.16NANA274Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0485ORAL DEVICE/APPLIANCE PRE7300.013.95411.010NANA275Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2402NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE2630029.09396.45NANA276Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE103311.8128.7NANA277Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603ELECTRIC BREAST PUMP45213.614.6NANA278Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7031REPLACEMENT FACEMASK INTERFA194111.1732.6NANA279Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND1471172.1NANA280Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA14317.1427.1NANA281Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 021550.994.7179.8NANA282Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7030CPAP FULL FACE MASK1380.992.2238.2NANA283Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER FOLDING WHEELED W/1360.9924.2423.6NANA284Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE13180.953.8126.4NANA285Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604HOSP GRADE ELEC BREAST PU4350.894.9168.1NANA286Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7031REPLACEMENT FACEMASK INTERFA194111.1732.6NANA287Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND1471172.1NANA288Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA14317.1427.1NANA289Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3260POST-OP SHOE CANVAS56184.2NANA290Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA551303.9NANA291Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9500HIT ANTIBIOTIC Q24H DIEM4414.1115NANA292Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW421274.6NANA293Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205ORTHO DVC REPAIR PER 15 M3511.9232.1NANA294Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9379HIT NOC PER DIEM3116.391.4NANA295Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1390OXYGEN CONCENTRATOR2516.2861.5NANA296Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0986MAN W/C PUSH-RIM POWR SYS101256.90NANA297Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2622ADJ SKIN PRO W/C CUS WD<2200.5388.40NANA298Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4161ENTERAL FORM,PEDS, HYDROLYZED/AMINO ACID/PEPTIDE CHAIN PROT,100 CAL=1 UN1300.15486.10NANA299Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA6533GRADIENT COMPRESSION STK THIGH LEN 18-30 MMHG EA800.13528.60NANA300Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0652PNEUMATIC COMPRESS SEGMNT W GRAD1100.09417.20NANA301Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0766ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE1400.07551.30NANA302Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0739REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS4100.0213.4569.50NANA303Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2402NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE9300.0132.81022.20NANA304Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0601CPAP DEVICE1318003.8126.40NANA305Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S15411.528.8NANA306Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR9619.312.6216NANA307Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM2814.824.6NANA308Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1970AFO PLASTIC MOLDED W/ANKLE J25130.8NANA309Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR790.994.322.6NANA310Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF580.9829.1NANA311Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE540.9833.7NANA312Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1310.97517.4NANA313Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL0464TLSO 4MOD SACRO-SCAP PRE270.931.839.2NANA314Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION1020.8933NANA315Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S15411.528.8NANA316Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR9619.312.6NANA317Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM2814.824.6NANA318Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1970AFO PLASTIC MOLDED W/ANKLE J25130.8NANA319Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2510.313.8NANA320Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0693UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL24123.6NANA321Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260HOSP BED SEMI-ELECTR W/ MATT2310.415.5NANA322Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP1919.3NANA323Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0691UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS18127.3NANA324Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6212FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA16131.4NANA325Carrier E2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399DURABLE MEDICAL EQUIPMENT MISC500.235.7NANA326Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab5124NANA327Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified11120NANA328Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination1196NANA329Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1945Afo, Molded To Patient Model, Plastic, Rigid Anterior Tibial Section1196NANA330Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)20.536NANA331Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive10120NANA332Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL0650Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf6189NANA333Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6550Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories5134153NANA334Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each5134153NANA335Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable5134153NANA336Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2755Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only5188NANA337Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab5124NANA338Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified11120NANA339Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination1196NANA340Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1945Afo, Molded To Patient Model, Plastic, Rigid Anterior Tibial Section1196NANA341Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)20.536NANA342Carrier F2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0694Ultraviolet multidirectional light therapy system in 6 ft cabinet, includes bulbs/lamps, timer, and eye protection400.252976NANA343Carrier F2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, 1 unit = 1 day supply3800.0331100NANA344Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.898.5NANA345Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS5144.7NANA346Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE100.814.835.4NANA347Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D290.798.529.2NANA348Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC90.7814.838.5NANA349Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS130.7712.222NANA350Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0294HOSPITAL BED SEMI-ELEC W/O SIDE RAILS W/MATTRSS40.7591NANA351Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0606AUTO EXT DEFIB W/INTGR ECG ANALY GARMENT TYPE50.698.8100.9NANA352Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS70.4379.2NANA353Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE4062.6NANA354Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.895.5NANA355Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS5144.7NANA356Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2611GEN WC BACK CUSHN WDTH LT 22 IN HT MOUNT HARDWARE3122.477.1NANA357Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA6550WND CARE SET NEG PRSS WND TX ELEC PUMP SPL3149.2124.7NANA358Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7000CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH3149.2124.7NANA359Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE3149.2124.7NANA360Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2624SKIN PROTECT and POSITIONING WC CUSH WIDTH LT 22 IN3122.432.9NANA361Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1960AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB3193.7NANA362Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0295HOSP BED SEMI-ELEC W/O SIDE RAILS W/O MATTRSS2117.3326.1NANA363Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0108OTHER ACCESSORIES2122.44.9NANA364Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2623PROSTHETIC EYE PLASTIC CUSTOM101140.8NANA365Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0766ELEC STIM DVC U CANCER TX INCL ALL ACC ANY TYPE200.577.3NANA366Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2628FABRICATION AND FITTING OF OCULAR CONFORMER200.572.2NANA367Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2627SCLERAL COVER SHELL200.572.2NANA368Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS300.335.664.7NANA369Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL8699PROSTHETIC IMPLANT NOT OTHERWISE SPECIFIED300.33215.4NANA370Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0667SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG300.3363NANA371Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS700.2979.2NANA372Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC900.1114.838.5NANA373Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE1000.114.835.4NANA374Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab2840.993.39NANA375Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each260.93143.35NANA376Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair280.86102.779.2NANA377Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified870.78102.04NANA378Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)580.7876.54NANA379Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr300.6466.98164.4NANA380Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0606Aed Garment With Electrocardiogram Analysis250.6431.5460NANA381Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive380.683.4146.3NANA382Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications570.4386.2NANA383Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (non-invasive)300.3782.38NANA384Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861Pwc Gp3 Std Mult Pow Opt S/b131159.16NANA385Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2622Skin Protection Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth11196NANA386Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8614Cochlear Device/system10191.64NANA387Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2617Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type6163NANA388Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement6154.86NANA389Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2609Custom Fabricated Wheelchair Seat Cushion, Any Size6166NANA390Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1161Manual Adult Size Wheelchair, Includes Tilt In Space61111.27NANA391Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260Hospital Bed, Seimi-electric (head And Foot Adjustment), With Any Type5185.33NANA392Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8694Auditory Osseointegrated Device, Transducer/actuator, Replacement Only, Each5187.43NANA393Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8691Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/actuator, Replacement Only, Each5179.06NANA394Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)580176.54NANA395Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications570186.2NANA396Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5856Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System,40178NANA397Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications30196NANA398Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8690Aud Osseo Dev, Int/ext Comp20152.8NANA399Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr3000.666.98NANA400Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0483High Frequency Chest Wall Oscillation Air-pulse Generator System, (inc1100.588.7NANA401Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0986Manual Wheelchair Accessory, Push-rim Activated Power Assist, Each100.5120NANA402Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0606Aed Garment With Electrocardiogram Analysis2500.2931.5460NANA403Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0766Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Type1000.272455.79NANA404Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate417.67432NANA405Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi1191.24NANA406Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0483High frequency chest wall oscillation system, includes all accessories and supplies, each1123.75NANA407Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1141.07NANA408Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2540.981.12NANA409Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate90.899.79NANA410Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor1024.06NANA411Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0995Wheelchair accessory, calf rest/pad, replacement only, each10139.76NANA412Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2361Power wheelchair accessory, 22nf sealed lead acid battery, each10139.76NANA413Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0484Oscillatory Positive Expiratory Pressure Device, Nonelectric, Any Type10NANA414Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate417.672NANA415Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi1191.2495NANA416Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1141.077.6NANA417Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0483High frequency chest wall oscillation system, includes all accessories and supplies, each1123.7516.5NANA418Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2540.981.12NANA419Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate90.899.79NANA420Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0484Oscillatory Positive Expiratory Pressure Device, Nonelectric, Any Type1015.8NANA421Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2361Power wheelchair accessory, 22nf sealed lead acid battery, each10139.7624NANA422Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor1024.06NANA423Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0995Wheelchair accessory, calf rest/pad, replacement only, each10139.76NANA424Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device35380.962.17NANA425Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate1650.952.18NANA426Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate660.914.21NANA427Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal150.663.03NANA428Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi310.5586NANA429Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine110.3690.09NANA430Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor120.33102.28NANA431Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER60.3344.45NANA432Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2615Pos back post/lat wdth <22in2024.98NANA433Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2293Contour back for ped size wc10NANA434Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1234Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adj, Wo Seating10NANA435Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA436Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneum Compres W/Cal Pressure10NANA437Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2231Solid seat support base10NANA438Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0667Seg Pneumatic Appl Full Leg10NANA439Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0641Multi-position stnd fram sys10110.86NANA440Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0637Combination sit to stand system, any size, with seat lift feature, with or without wheels1073.83NANA441Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0990Whellchair Elevating Leg Res10NANA442Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0328Ped hospital bed, manual10NANA443Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0483High frequency chest wall oscillation system, includes all accessories and supplies, each10NANA444Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0638Standing frame system, any size, with or without wheels1047.08NANA445Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2292Planar seat for ped size wc10NANA446Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in10126.74NANA447Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in10NANA448Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device10NANA449Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height10NANA450Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0950Tray10NANA451Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0956Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each10NANA452Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device35380.962.17NANA453Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate1650.952.18NANA454Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate660.914.2115.3NANA455Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal150.663.03NANA456Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi310.5586NANA457Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine110.3690.09NANA458Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor120.33102.2828.9NANA459Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER60.3344.456.2NANA460Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2615Pos back post/lat wdth <22in2024.9825NANA461Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2293Contour back for ped size wc10NANA462Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1234Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adj, Wo Seating103.2NANA463Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA464Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0652Pneum Compres W/Cal Pressure1032.6NANA465Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2231Solid seat support base1029.4NANA466Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0667Seg Pneumatic Appl Full Leg10NANA467Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height10NANA468Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1028.9NANA469Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0990Whellchair Elevating Leg Res10NANA470Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0328Ped hospital bed, manual1029.4NANA471Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0638Standing frame system, any size, with or without wheels1047.08NANA472Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in10126.746.1NANA473Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2292Planar seat for ped size wc10NANA474Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in102.4NANA475Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0641Multi-position stnd fram sys10110.86NANA476Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0637Combination sit to stand system, any size, with seat lift feature, with or without wheels1073.83NANA477Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0956Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each10NANA478Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0483High frequency chest wall oscillation system, includes all accessories and supplies, each10NANA479Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0950Tray10NANA480Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0760Osteogen Ultrasound Stimltor1200.08102.28NANA481Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399Durable Medical Equipment Mi3100.0386NANA482Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601Cont Airway Pressure Device3538002.17NANA483Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0747Elec Osteogen Stim Not Spine110090.09NANA484Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC21013.35NANA485Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV1100.2NANA486Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE11053.6NANA487Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM11075.756.9NANA488Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0747OSTOGNS STIM ELEC NONINVASV OTH THAN SP APPLIC20069.2NANA489Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC21013.35NANA490Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV1100.2NANA491Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE11053.6NANA492Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM11075.7NANA493Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/BACK-UP3121.859.5NANA494Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5679ADD LW EXT BK/AK CSTM MOLD/PRFAB NOT W/LOCK MECH30.6762.67NANA495Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5981ALL LOWER EXTREM PROSTH FLEX-WALK SYSTEM/EQUAL30.6752.9NANA496Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5321ABOVE KNEE OPEN END SACH FT ENDO SYS 1 AXIS KNEE30.3362.67NANA497Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5624ADDITION LOWER EXTREMITY TEST SOCKET ABOVE KNEE30.3362.67NANA498Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5631ADD LW EXT ABVE KNEE/KNEE DISARTIC ACRYLC SOCKT30.3362.67NANA499Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5649ADD LW EXT ISCHIAL CONTAINMENT/NARROW M-L SOCKET30.3362.67NANA500Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5650ADD LW EXT TOTAL CONTACT ABVE KNEE/KNEE DISARTC30.3362.67NANA501Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5671ADD LW EXTRM BELW/ABVE KNEE SUSP LOCK MECH30.3362.67NANA502Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5673ADD LW EXT CSTM MOLD/PRFAB FOR USE W/LOCK MECH30.3362.67NANA503Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/BACK-UP3121.859.5NANA504Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562HUMDIFIR HEATED USED W/POS ARWAY PRESSURE DEVICE2121.844.2NANA505Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE2120.7NANA506Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2820ADD LW EXT ORTH SFT INTERFCE MOLD BELW KNEE2147.25NANA507Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620ADDITION LOWER EXTREMITY TEST SOCKET BELOW KNEE2142.25NANA508Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637ADDITION LOWER EXTREMITY BELOW KNEE TOTAL CNTC2142.25NANA509Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5679ADD LW EXT BK/AK CSTM MOLD/PRFAB NOT W/LOCK MECH2142.25NANA510Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5685ADD LOW EXT PROS BELW KNEE SUSP/SEAL SLEEVE EA2142.25NANA511Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910ADD ENDOSKEL SYSTEM BELOW KNEE ALIGNABLE SYSTEM2142.25NANA512Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5940ADD ENDOSKEL SYSTEM BELW KNEE ULTRA-LGHT MATL2142.25NANA513Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)810309NANA514Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 3 TO 6 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)80.88948NANA515Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)80.75996NANA516Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20931ALLOGRAFT, STRUCTURAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)70.713.4361.71NANA517Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)170.654.2425.41NANA518Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO110.646.5528.36NANA519Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)80.63963NANA520Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DESKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR80.63969NANA521Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR80.63945NANA522Carrier M2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE180.56444NANA523Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)810309NANA524Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22612LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED713.4348NANA525Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);71024NANA526Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY. COUNSELING AND/OR COORDINATIO7110.2948NANA527Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 3 TO 6 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)80.88948NANA528Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)80.75996NANA529Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)170.654.2425.41NANA530Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20936POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO110.646.5528.36NANA531Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20931AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)80.63963NANA532Carrier M2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20930INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE180.56444NANA533Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22551Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C27142.71NANA534Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)90.8997.2484.54NANA535Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)270.8297.2461.33NANA536Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)110.8264.01NANA537Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)140.7166.08NANA538Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar200.7194.3682.72NANA539Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)100.797.2477.6NANA540Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)180.67194.3691.31NANA541Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar150.67194.3679.52NANA542Carrier A2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22585Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)110.5597.24113.88NANA543Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C27142.71NANA544Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22552Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)6149.55NANA545Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);513.5130.44NANA546Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction411.1626.16NANA547Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22846Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)3137.93NANA548Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20931Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)3177.56NANA549Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)210.130.13NANA550Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22630Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar2141.48NANA551Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar2141.48NANA552Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22855Removal of anterior instrumentation2122.48NANA553Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)1100.0964.01NANA554Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar1500.07194.3679.52NANA555Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)1800.06194.3691.31NANA556Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar2000.05194.3682.72NANA557Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)2700.0497.2461.33NANA558Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)140066.08NANA559Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22585Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)110097.24113.88NANA560Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22614Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)100097.2477.6NANA561Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)600194.3654.79NANA562Carrier A2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63056Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)40091.05NANA563Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44120REMOVAL OF SMALL INTESTINE210NANA564Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44625REPAIR BOWEL OPENING110NANA565Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33416REVISE VENTRICLE MUSCLE110NANA566Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61582CRANIOFACIAL APPROACH SKULL110NANA567Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58952RESECT OVARIAN MALIGNANCY1124NANA568Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38571LAPAROSCOPY LYMPHADENECTOMY110NANA569Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303MAST SIMPLE COMPLETE1172NANA570Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44139MOBILIZATION OF COLON1124NANA571Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633LUMBAR SPINE FUSION COMBINED20.560NANA572Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49320DIAG LAPARO SEPARATE PROC2096NANA573Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44120REMOVAL OF SMALL INTESTINE210NANA574Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44625REPAIR BOWEL OPENING110NANA575Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33416REVISE VENTRICLE MUSCLE110NANA576Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61582CRANIOFACIAL APPROACH SKULL110NANA577Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58952RESECT OVARIAN MALIGNANCY1124NANA578Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571LAPAROSCOPY LYMPHADENECTOMY110NANA579Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303MAST SIMPLE COMPLETE1172NANA580Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44139MOBILIZATION OF COLON1124NANA581Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633LUMBAR SPINE FUSION COMBINED20.560NANA582Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49320DIAG LAPARO SEPARATE PROC2096NANA583Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTORECOMY WITH/WITHOUT REMOVAL OF TUBE(S) - OVARY(S)12169.74161.590NANA584Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49000EXPLORATORY LAPAROTOMY-CELIOTOMY WITH OR WITHOUT BIOPSY91086.560NANA585Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION81044.850NANA586Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTHERAPY ADMNIISTRATION TO INITIALIZE PROLONG CHEMOTHERAPY WITH I NFUSION PUMP817.6883.30NANA587Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130HIP JOINT REPLACEMENT BY PROSTHESIS OR ARTIFICIAL JOINT230.96035.550NANA588Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840PLACEMENT OF SPINAL INSTRUMENTATION IN NECK ACROSS A SINGLE LEVEL TO CORRECT SPINAL DEFORMITY120.92064.480NANA589Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSERTION OF METALLIC CAGE OR MESH DEVICE BETWEEN TWO VERTEBRAE WITH SCREWS AND FLANGES160.88068.910NANA590Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT OF DONOR OR SYNTHETIC MATERIAL-ADD ON120.83045.250NANA591Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047LAMINECTOMY OF SINGLE VERTEBRAE EITHER UNILATERAL OR BILATERAL OF LUMBAR SPINE150.67043.10NANA592Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048ADDITIONAL VERTEBRAL LAMINECTOMY, FACETECTOMY, and FORAMINOTOMY PROCEDURES100.6049.270NANA593Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTORECOMY WITH/WITHOUT REMOVAL OF TUBE(S) - OVARY(S)12169.74161.590NANA594Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49000EXPLORATORY LAPAROTOMY-CELIOTOMY WITH OR WITHOUT BIOPSY91086.560NANA595Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447ARTHROPLASTY OF KNEE CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS OF THE KNEE810127.470NANA596Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMOTHERAPY ADMNIISTRATION TO INITIALIZE PROLONG CHEMOTHERAPY WITH I NFUSION PUMP817.6883.30NANA597Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION81044.850NANA598Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558ARTHRODESIS-ANTERIOR INTERBODY WITH MINI DISKECTOMYOF LUMBAR SPINE71036.390NANA599Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571LAPAROSCOPY WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY710.7179.470NANA600Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20936AUTOGRAFT DURING SPINAL SURGERY ONLY; LOCAL THRU SAME INCISION71038.30NANA601Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842PLACEMENT OF SPINAL INTRUMENTATION; 3 TO 6 VERTEBRAE SEGMENT61063.490NANA602Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47120HEPATECTOMY RESECTION OF LIVER; PART LOBECTOMY OF LIVER617.23251.890NANA603Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61760STEREOTACTIC IMPLANT DEPTH ELECTRODES-CEREBRUM1010100.880NANA604Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22610THORACIC SPINE FUSION101000NANA605Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63046LAMINECTOMY SINGLE VERTEBRAL SEGMENT-UNILATERAL/BILATERLA; THORACIC REGION101000NANA606Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61781COM:UTED TOMOGRAPHY or MAGNETIC RESONANCE IMAGING DURING PROCEDURE OF INTRADUAL CRANIAL PROCEDURE300.33091.230NANA607Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27487REVISION TOTAL KNEE ARTHROPLASTY; FEMORAL AND WHOLE TIBIA COMPARTMENTS300.33039.940NANA608Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22842PLACEMENT OF SPINAL INTRUMENTATION; 3 TO 6 VERTEB SEGMENT600.17063.490NANA609Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22614ARTHRODESIS-POST/POSTLATERAL TECHNIQUE; EACH ADD VERTEBRAE SEGMENT700.14060.710NANA610Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63048ADDITIONAL VERTEBRAL LAMINECTOMY, FACETECTOMY, and FORAMINOTOMY PROCEDURES1000.1049.270NANA611Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY5112.95128.38600NANA612Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV990.996.42112.83NANA613Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES55260.9840.54530.38NANA614Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD116820.9737.54247.41NANA615Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59514CESAREAN DELIVERY ONLY480.960.8855.73NANA616Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y550.9566.05NANA617Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAP SLEEVE GASTRECTOMY380.92140.76NANA618Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1010.95.4434.69NANA619Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU580.7453.131068.04NANA620Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD1540.5937.3270.48NANA621Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY5112.95128.38NANA622Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPARO RADICAL PROSTATECT2110.48121.39NANA623Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58960EXPLORATION OF ABDOMEN2111.0121.99NANA624Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT362SURGERY2010.1745.39NANA625Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT656HOSPICE GEN INPT/NOT RESP181157.0273.52NANA626Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61781SCAN PROC CRANIAL INTRA1711.1340.63NANA627Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50543LAPARO PARTIAL NEPHRECTOM16112.5936.42NANA628Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487REVISE/REPLACE KNEE JOINT15152.78178.65NANA629Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE TO FEMALE141383.01NANA630Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27570FIXATION OF KNEE JOINT1410.744.28NANA631Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21141LEFORT I-1 PIECE W/O GRAF1012103.45NANA632Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT53854TRANSURETHRAL DESTRUCT PROSTAT TISSUE;BY RADIOFRQ WATER THERMOTHERPY200.5483.88NANA633Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33270INS/REP SUBQ DEFIBRILLATO300.3323.82596.94NANA634Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22514PERQ VERTEBRAL AUGMENTATI300.3346.7347.14NANA635Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33945TRANSPLANTATION OF HEART400.2581.76211.16NANA636Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43645LAP GASTR BYPASS INCL SML800.13159.29NANA637Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD15400.0237.3270.48NANA638Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y5500.0266.05NANA639Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU5800.0253.131068.04NANA640Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT120ROOM AND BOARD116820037.54247.41NANA641Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400OBSTETRICAL CARE2713.8194.23NANA642Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510CESAREAN DELIVERY2110.1177.22NANA643Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE,LEVL I16162.12NANA644Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT367SURGERY141162.31NANA645Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES12040.9945.98NANA646Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD48300.9737.0772.8NANA647Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130TOTAL HIP ARTHROPLASTY440.7538.01339.93NANA648Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y120.7531.32203.96NANA649Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558LUMBAR SPINE FUSION150.5357.11613.99NANA650Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD880.5234.8774.87NANA651Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400OBSTETRICAL CARE2713.8194.23NANA652Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510CESAREAN DELIVERY2110.1177.22NANA653Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE,LEVL I16162.12NANA654Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT367SURGERY141162.31NANA655Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTO1111.114.1NANA656Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPARO RADICAL PROSTATECT10191.33NANA657Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUM JNT TOTAL SHOULDER91127.07NANA658Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620REPAIR BOWEL OPENING810.56170.91NANA659Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY8128.443.63NANA660Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY7139.86NANA661Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775LAP SLEEVE GASTRECTOMY900.22534.68NANA662Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR1100.1876.86346.45NANA663Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558LUMBAR SPINE FUSION1500.1357.11613.99NANA664Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD8800.0234.8774.87NANA665Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT5157.1NANA666Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT41NANA667Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG314.5NANA668Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9328INJECTION TEMOZOLOMIDE 1 MG2129.8NANA669Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21NANA670Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38240BONE MARROW STEM CELL TRANSPLANTATION, ALLOGENIC210.3NANA671Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS2115.8NANA672Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCQ5006HOSPICE CARE PROV INPATIENT HOSPICE FACILITY11NANA673Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ7187INJ VONWILLEBRND FACTOR CMPLX HUMN RISTOCETIN IU114.3600NANA674Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCD0301D0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,COMORBIDITY IN TIER 3110.1NANA675Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT5157.1NANA676Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT41NANA677Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG314.5NANA678Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9328INJECTION TEMOZOLOMIDE 1 MG2129.8NANA679Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21NANA680Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240BONE MARROW STEM CELL TRANSPLANTATION, ALLOGENIC210.3NANA681Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS2115.8NANA682Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5006HOSPICE CARE PROV INPATIENT HOSPICE FACILITY11NANA683Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ7187INJ VONWILLEBRND FACTOR CMPLX HUMN RISTOCETIN IU114.3NANA684Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCD0301D0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,COMORBIDITY IN TIER 3110.1NANA685Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar210.816718.29NANA686Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft400.82055NANA687Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)200.84361NANA688Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)150.8289118.3NANA689Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)180.78372NANA690Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)370.762779NANA691Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)160.7582NANA692Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Medical/Surgical/GYN3550.722367NANA693Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)200.73775NANA694Carrier F2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar220.682366NANA695Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)1113767NANA696Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar1013386NANA697Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22634Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)71186NANA698Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed714744NANA699Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50545Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)51243NANA700Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36223Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed4187NANA701Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36224Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed4187NANA702Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36226Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed4187NANA703Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36227Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)4187NANA704Carrier F2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36228Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (List separately in addition to code for primary procedure)4187NANA705Carrier F2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33418Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis10126NANA706Carrier F2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22634Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)700.14186NANA707Carrier F2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar1000.13386NANA708Carrier F2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)1600.0682NANA709Carrier F2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue121Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Medical/Surgical/GYN35500.012367NANA710Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General10132.6NANA711Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR130.92159.9NANA712Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047LAM FACETECTOMY AND FORAMOTOMY 1 SEGMENT LUMBAR110.91159NANA713Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048LAM FACETECTOMY and FORAMTOMY 1 SGM EA CRV THRC/LMBR100.9145.9NANA714Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION130.85132.8NANA715Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT130.8542.7NANA716Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED120.83132NANA717Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP110.8232.342.2NANA718Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION110.82139.2NANA719Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD190.797.5133.6NANA720Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General10132.6NANA721Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33518CORONARY ARTERY BYP W/VEIN and ARTERY GRAFT 2 VEIN814108.3NANA722Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST6114.443NANA723Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9070CYCLOPHOSPHAMIDE 100 MG6117.964.1NANA724Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY615.150.6NANA725Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ1453INJECTION FOSAPREPITANT 1 MG5130.1114.9NANA726Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL51135.6NANA727Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS5145.9NANA728Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61624TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS5118.7131NANA729Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36226SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY419.7160.1NANA730Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue164Other Room & Board - Sterile Environment10173.9NANA731Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22846ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS101145.6NANA732Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27685LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX101241.7NANA733Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27702ARTHROPLASTY ANKLE W/IMPLANT101241.7NANA734Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33979INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC10149.3NANA735Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20680REMOVAL IMPLANT DEEP300.6742.5141.8NANA736Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue206Intensive Care - Intermediate (ICU)200.550.1NANA737Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22552ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC300.33103.8NANA738Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120Room & Board - Semiprivate - 2 Beds - General1000.332.6NANA739Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55866LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT400.255.170.1NANA740Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27487Revis.totl Knee Arthroplas,w/wo Allogft;10152.8NANA741Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27134Revis.tot.hip Arthropl;both Compnts9190NANA742Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)310.9748135.77NANA743Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Replacement Knee Total850.9182.05NANA744Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple1160.91244NANA745Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy490.9110.4NANA746Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22551Arthodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C2420.86875.13NANA747Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, Combnd Post Or Postlat Techq W/post Interbdy Techq Incl Laminctmy And/or Discctmy Suffcnt To Prepre Interspce (oth Thn For Decomp), Sgl Interspce&segmnt; Lumbar430.7324102.92NANA748Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrod,interbdy Tech;lumbar,allogf650.67117.33NANA749Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy W Facetectomy-lumbar310.5594.86NANA750Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487Revis.totl Knee Arthroplas,w/wo Allogft;10152.8NANA751Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134Revis.tot.hip Arthropl;both Compnts9190NANA752Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22802Arthrod,post,spin.deform,gft;7+vert7161.71NANA753Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75894Transcatheter Therapy Embolize Any Meth6168.57NANA754Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22533Arthrodesis, Lateral Extracavitary Technique, Including Minimal Diskectomy To Prepare Interspace; Lumbar512467.2NANA755Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22804Arthrodesis, 13 Or More Vertebral Segments41100.8NANA756Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38241Hematopoietic Progenitor Cell (hpc);autologous Transplantation412464NANA757Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27486Revis.totl Knee Arthroplas;1 Compon4136NANA758Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63056Transped App/decomp;sgle;lumb3172NANA759Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy W Facetectomy-cervical504884NANA760Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22551Arthodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C242010.33333375.13NANA761Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)31012135.77NANA762Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex Op Male To Female801121.6NANA763Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22600Fusion Cervical Post < C18011153NANA764Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22630Arthrodesis Post Interbody-lumbar701154NANA765Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22614Arthrodesis, Each Additional Vertebral Segment401216NANA766Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20931Allograft, Structural, For Spine Surgery Only; (list Separately In Addition To Code For Primary Procedure)101108NANA767Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT38999Unlisted Proc Hemic/lymphatic Syst101272NANA768Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22214Osteotomy Spine Post Appr-lumbar10172NANA769Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple11600.91244NANA770Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft7123.04667278NANA771Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)5121.82893333NANA772Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);311.39000000151.785NANA773Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)3113.96756852NANA774Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)110.9113.08NANA775Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)40.757.796146042NANA776Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22600Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment30.679.986528055NANA777Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47600Cholecystectomy;4068.6544444546.25231454NANA778Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47605Cholecystectomy; with cholangiography3068.6544444535.73902736NANA779Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis3072.79083333NANA780Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft7123.05NANA781Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)5121.83NANA782Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);311.3951.79NANA783Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)3113.97NANA784Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component21139.77NANA785Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))2169.77NANA786Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)2133.62199.4NANA787Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)210.09NANA788Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22552Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)210.41NANA789Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar2154.14NANA790Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar2133.62NANA791Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2210.41NANA792Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23470Arthroplasty, glenohumeral joint; hemiarthroplasty2123.7632.3NANA793Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)21205.43NANA794Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)201205.43NANA795Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63042Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar10167.21NANA796Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT52332Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)10122.11NANA797Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63012Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)10167.21NANA798Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar200.533.62NANA799Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)200.533.62NANA800Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar200.554.14NANA801Carrier I2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)500.221.83NANA802Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft640.860.8932.22NANA803Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)310.840.7361.39NANA804Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar250.80.1864.04NANA805Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)280.790.1861.12NANA806Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)270.7872.88NANA807Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar340.770.1868.48NANA808Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)310.7763.78NANA809Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar220.7756.5NANA810Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)540.740.3570.67NANA811Carrier J2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)250.720.1552.33NANA812Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22843Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)7189.4817.8NANA813Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed712.989.0436.7NANA814Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor71111.3527.3NANA815Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33340Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation51106.12NANA816Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)51123.06NANA817Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical4186.09NANA818Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27486Revision of total knee arthroplasty, with or without allograft; 1 component410.4152.8NANA819Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47370Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency4189.51NANA820Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63012Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)4153.19NANA821Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29882Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)410.840.73NANA822Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27446Arthroplasty, knee, condyle and plateau; medial OR lateral compartment600.5168.88NANA823Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43282Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh300.33148.34NANA824Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21141Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft300.33183.67NANA825Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95720Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret600.1785.74NANA826Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21085Impression and custom preparation; oral surgical splint700.14142.47NANA827Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21196Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation700.14146.54NANA828Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20931Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)1400.0759.64NANA829Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)1900.050.1878.39NANA830Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22551Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C22100.050.7363.36NANA831Carrier J2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar2500.040.1864.04NANA832Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Adult26915.972.1489.3NANA833Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Adolescent4917.5828.31NANA834Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Child15111.130.02NANA835Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS714642.5NANA836Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER516542.5NANA837Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Inpatient Adult515.630.02NANA838Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Adult Intensive510.05213.9NANA839Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Acute Inpatient Adult410.9642.5NANA840Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Inpatient Detox Adult470.985.940.05NANA841Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR80.8846610NANA842Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Adult26915.972.14NANA843Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Adolescent4917.5828.31NANA844Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Child15111.130.02NANA845Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER5165NANA846Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASUD Inpatient Adult515.630.02NANA847Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Adult Intensive510.05NANA848Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Acute Inpatient Adult410.96NANA849Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT317166NANA850Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANTERIOR INTERBODY LUMBAR21070NANA851Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C221109NANA852Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96413CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG4128.3568.2NANA853Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG2128.35NANA854Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96411CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG2128.35NANA855Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96415CHEMOTHERAPY ADMN IV INFUSION TQ EA HR2168.235NANA856Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96417CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR2168.2NANA857Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT26951AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR2092.3NANA858Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96413CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG4128.3568.2NANA859Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG2128.35NANA860Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96411CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG2128.35NANA861Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96415CHEMOTHERAPY ADMN IV INFUSION TQ EA HR2168.2NANA862Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96417CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR2168.2NANA863Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRMHResidential Mental Health190.741.372NANA864Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalDAADetoxification450.530.572NANA865Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalMENMental Health1120.510.2184NANA866Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse530.451.721NANA867Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalREHRehabilitation360.442.657NANA868Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalDARDrug & Alcohol Rehabilitation60.170NANA869Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalDAADetoxification1614.5229.5NANA870Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalDARDrug & Alcohol Rehabilitation1100NANA871Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalMENMental Health570.980.4232.84NANA872Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse240.961118NANA873Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRMHResidential Mental Health240.791458NANA874Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalREHRehabilitation140.715.1477.14NANA875Carrier A2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99251Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 20 minutes1041.59NANA876Carrier A2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99251Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 20 minutes1041.59NANA877Carrier N2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASubstance Abuse Residential3124NANA878Carrier N2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADetox1124NANA879Carrier N2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMental Health Inpatient1124NANA880Carrier N2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASubstance Abuse Residential3124NANA881Carrier N2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADetox1124NANA882Carrier N2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMental Health Inpatient1124NANA883Carrier B2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Psychiatric Admission1126.800NANA884Carrier B2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Psychiatric Admission1126.800NANA885Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE51164.53NANA886Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR21350.4NANA887Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT1189.12NANA888Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT912OTHER THERAPY SERV11590.18NANA889Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ACCOM SEMI-PRVT DETOX/2BD2300.9928.55183.66NANA890Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ACCOM SEMI-PRVT 2 BED PSY7970.9822.57277.87NANA891Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV2280.9732.67740NANA892Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3010.8870.79321.87NANA893Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS30.67318.51NANA894Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH20.5852.84NANA895Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE51164.53NANA896Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR21350.4NANA897Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT1189.12NANA898Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT912OTHER THERAPY SERV11590.18NANA899Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ACCOM SEMI-PRVT DETOX/2BD2300.9928.55183.66NANA900Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ACCOM SEMI-PRVT 2 BED PSY7970.9822.57277.87NANA901Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV2280.9732.67740NANA902Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3010.8870.79321.87NANA903Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS30.67318.51NANA904Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH20.5852.84NANA905Carrier C2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD30100.0170.79321.87NANA906Carrier C2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT900OTHER THERAPY SERV2280032.67740NANA907Carrier C2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT126ACCOM SEMI-PRVT DETOX/2BD2300028.55183.66NANA908Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY1187.96NANA909Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900PSYCH TREATMENTS GEN THER1900.9932.06NANA910Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ROOM AND BOARD3370.9734423.7NANA911Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ROOM AND BOARD910.9327.084.07NANA912Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3110.8939.95732.43NANA913Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY1187.96NANA914Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900PSYCH TREATMENTS GEN THER1900.9932.06NANA915Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ROOM AND BOARD3370.9734423.7NANA916Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ROOM AND BOARD910.9327.084.07NANA917Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3110.8939.95732.43NANA918Carrier D2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT124ROOM AND BOARD33700.0134423.7NANA919Carrier D2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD31100.0139.95732.43NANA920Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC57117.5NANA921Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION5121.2NANA922Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV319.7NANA923Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0005ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN1126.2NANA924Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99284EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY1145.8NANA925Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue129ROOM & BOARD, SEMIPRIVATE TWO-BED - OTHER1168.2NANA926Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP100.933.2NANA927Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC120.8326.1NANA928Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99255INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN1072.4NANA929Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue136ROOM & BOARD, THREE AND FOUR BEDS - DETOXIFICATION1098.4NANA930Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC57117.5NANA931Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION5121.2NANA932Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV319.7NANA933Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0005ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN1126.2NANA934Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99284EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY1145.8NANA935Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue129ROOM & BOARD, SEMIPRIVATE TWO-BED - OTHER1168.2NANA936Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue114ROOM & BOARD, PRIVATE - PSYCHIATRIC11NANA937Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP100.933.2NANA938Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC120.8326.1NANA939Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99255INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN1072.4NANA940Carrier F2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric312039NANA941Carrier F2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation80.751638NANA942Carrier F2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric312039NANA943Carrier F2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation80.751638NANA944Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE21117.5NANA945Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY2165NANA946Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric11NANA947Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue450Emergency Room - General10432NANA948Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue424Physical Therapy - Evaluation or Reevaluation10NANA949Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue259Pharmacy - Other Pharmacy10NANA950Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue440Speech-Language Pathology - General10NANA951Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue300Laboratory - General10NANA952Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue730EKG/ECG (Electrocardiogram) - General10NANA953Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue636Drugs Requiring Specific Identification - Drug Requiring Det10NANA954Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE21117.5NANA955Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY2164.3NANA956Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric110NANA957Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General11146.3NANA958Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue259Pharmacy - Other Pharmacy10NANA959Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue450Emergency Room - General10NANA960Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue440Speech-Language Pathology - General10NANA961Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue636Drugs Requiring Specific Identification - Drug Requiring Det10NANA962Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue730EKG/ECG (Electrocardiogram) - General10NANA963Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue214Coronary Care - Intermediate Coronary Care Unit (CCU)10NANA964Carrier G2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120Room & Board - Semiprivate - 2 Beds - General101146.3NANA965Carrier H2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem3134800NANA966Carrier H2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation60.673136NANA967Carrier H2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric40.529NANA968Carrier H2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem3103480NANA969Carrier H2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation60.673136NANA970Carrier H2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric40.529NANA971Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol And/Or Drug Services21132.43NANA972Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed1121.85NANA973Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services4024.56NANA974Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services10142.44NANA975Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services1043.35NANA976Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99233Alcohol And/Or Drug Services10NANA977Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720Alcohol And/Or Drug Services1067.56NANA978Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0018Alcohol and/or other drug treatment program, per diem1073.15NANA979Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0010Psychiatric diagnostic evaluation10NANA980Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0011Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret10124.9NANA981Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem21132.4342.4NANA982Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791Psychiatric diagnostic evaluation1121.8514.4NANA983Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services4024.5618.9NANA984Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services10142.44NANA985Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99233Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed1019.3NANA986Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0010Alcohol And/Or Drug Services10NANA987Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0018Alcohol And/Or Drug Services1073.15NANA988Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95720Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret1067.56NANA989Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services1043.35NANA990Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services10124.9NANA991Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE560.881.2954.86NANA992Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318REDUCTION MAMMAPLASTY410.591.7614.63NANA993Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)710.481.0156.79NANA994Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)420.361.7175.43NANA995Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89258CRYOPRESERVATION; EMBRYO420.311.7186.29NANA996Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4015COMPLETE IN VITRO FERTILIZATION CYCLE, CASE RATE; NOT OTHERWISE SPECIFIED290.312.4882.76NANA997Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION510.21.4164.47NANA998Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE610.161.1874.75NANA999Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89290BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS390.051.8578.77NANA1000Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89291BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS390.051.8570.77NANA1001Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58322ARTIFICIAL INSEMINATION; INTRA-UTERINE2313.1365.74NANA1002Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT1714.2431.06NANA1003Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE560.881.2954.86NANA1004Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499UNLISTED EVALUATION AND MANAGEMENT SERVICE160.884.527NANA1005Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR230.783.1329.22NANA1006Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63030LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, LUMBAR250.762.8832.64NANA1007Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED270.742.6716.89NANA1008Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318REDUCTION MAMMAPLASTY410.591.7614.63NANA1009Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)710.481.0156.79NANA1010Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)420.361.7175.43NANA1011Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS4042MANAGEMENT OF OVULATION INDUCTION (INTERPRETATION OF DIAGNOSTIC TESTS AND STUDIES, NON-FACE-TO-FACE MEDICAL MANAGEMENT OF THE PATIENT), PER CYCLE20112NANA1012Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT76948ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, IMAGING AND INTERPRETATION200.6712NANA1013Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58970FOLLICLE PUNCTURE FOR OOCYTE RETRIEVAL, ANY METHOD200.512NANA1014Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT76942ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE), IMAGING SUPERVISION AND INTERPRETATION200.512NANA1015Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22856TOTAL DISC ARTHROPLASTY (ARTIFICIAL DISC), ANTERIOR APPROACH, INCLUDING DISCECTOMY WITH END PLATE PREPARATION (INCLUDES OSTEOPHYTECTOMY FOR NERVE ROOT OR SPINAL CORD DECOMPRESSION AND MICRODISSECTION); SINGLE INTERSPACE, CERVICAL200.448NANA1016Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36471INJECTION OF SCLEROSING SOLUTION; MULTIPLE VEINS, SAME LEG100.3348NANA1017Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58974EMBRYO TRANSFER, INTRAUTERINE200.2912NANA1018Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS4015COMPLETE IN VITRO FERTILIZATION CYCLE, CASE RATE; NOT OTHERWISE SPECIFIED200.112NANA1019Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89258CRYOPRESERVATION; EMBRYO200.0712NANA1020Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)200.0512NANA1021Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Computed tomography, abdomen and pelvis; without contrast material3040.9410.55.5NANA1022Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography2800.915.8NANA1023Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material2290.884.5NANA1024Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)1240.876.1NANA1025Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material1940.789.5NANA1026Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility5500.779.922.8NANA1027Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97014Application of a modality to 1 or more areas; electrical stimulation (unattended)1620.7716.224.4NANA1028Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes5050.751223.6NANA1029Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes2410.7324.7NANA1030Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities2880.7125.5NANA1031Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29827Arthroscopy, shoulder, surgical; with rotator cuff repair26167.57NANA1032Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73722Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)1413.61NANA1033Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303Transthoracic echocardiography for congenital cardiac anomalies; complete1311.73NANA1034Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77046Magnetic resonance imaging, breast, without contrast material; unilateral12120.092.04NANA1035Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70480Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material1210.02NANA1036Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72125Computed tomography, cervical spine; without contrast material1112.82NANA1037Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction11145.32NANA1038Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic915.38NANA1039Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64495Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)915.33NANA1040Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73218Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)915.92NANA1041Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58552Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)9155.22NANA1042Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT42145Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)10193.99NANA1043Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58353Endometrial ablation, thermal, without hysteroscopic guidance101173.5NANA1044Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43282Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh101317.1NANA1045Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22899Unlisted procedure, spine101101.25NANA1046Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22858Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure)400.50.44188.61NANA1047Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical400.50.44188.61NANA1048Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64590Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling200.581.09NANA1049Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29867Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)200.517.01NANA1050Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43281Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh500.4206.86NANA1051Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)500.4217.56NANA1052Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77049Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral22112NANA1053Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI, brain, including brain stem; without contrast material(s), followed by contrast material(s) and further sequences510.9612NANA1054Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483Injection, anesthetic agent and/or steroid, transforaminal epidural;lumbar or sacral, single level220.9512NANA1055Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Computed tomography, abdomen and pelvis; with contrast material(s770.9112NANA1056Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, any joint of lower extremity; without contrast materia810.8812NANA1057Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260Computed tomography (CT), thorax; with contrast material(s)570.8812NANA1058Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74183MRI, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences240.8312NANA1059Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141MRI, spinal canal and contents, cervical; without contrast material400.8212NANA1060Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI spinal canal and contents, lumbar; without contrast material520.6912NANA1061Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI, any joint of upper extremity; without contrast material(s)300.6712NANA1062Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63650Percutaneous implantation of neurostimulator electrode array, epidural12112NANA1063Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75571Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium12112NANA1064Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ1745INFLIXIMAB NOT BIOSIMIL 10MG10172126NANA1065Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY814861.7NANA1066Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63042LAMINOTOMY SINGLE LUMBAR4112NANA1067Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ3380INJECTION, VEDOLIZUMAB4112NANA1068Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION4112NANA1069Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213OFFICE O/P EST LOW 20-29 MIN4190NANA1070Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30465REPAIR NASAL STENOSIS4166NANA1071Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29999Unlisted procedure, arthroscopy4112NANA1072Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue551SKILLED NURSING VISIT IN HOME1260.9818.97129.960NANA1073Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99601HOME INFUSION/SPCAILTY DRUG ADMINISTRATION-SKILLED NURSE VISIT1090.90129.610NANA1074Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION OF ONABOTULINUMTOXINA990.8722.83206.590NANA1075Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483TRANSFORAMINAL EPIDURAL INJECTION INTO A SINGLE LEVEL EITHER LUMBAR OR SACRAL800.8434.84234.690NANA1076Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFNITIVE DRUG TEST FOR DRUG CLASSES 8-142020.634.4899.430NANA1077Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT VISIT ESTABLISHED1330.56103.53261.342.78NANA1078Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT0296TEXTENDED ECG RECORDING710.55219.48153.640.15NANA1079Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFNITIVE DRUG TEST FOR DRUG CLASSES 1-71480.530118.50NANA1080Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0483DEFNITIVE DRUG TEST FOR DRUG CLASSES 22+1390.370116.460NANA1081Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0482DEFNITIVE DRUG TEST FOR DRUG CLASSES 15-211340.360113.640NANA1082Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99442PHONE EVALUTATION/MANAGEMENT PHYSICIAN WITH ESTABLISHED PATIENT OF 11-20 MINUTES67100.030NANA1083Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5101INJECTION OF FILGRASTIM-SNDZ(ZARXIO), BIOSIMILAR 1 MICROGRAM53111.1767.280NANA1084Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30520SEPTOPLASTY OF DEVIATED SEPTUM4112.67119.350NANA1085Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99443PHONE EVALUTATION/MANAGEMENT PHYSICIAN WITH ESTABLISHED PATIENT OF 21-30 MINUTES261000NANA1086Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99441PHONE EVALUTATION/MANAGEMENT PHYSICIAN WITH ESTABLISHED PATIENT OF 5-10 MINUTES251000NANA1087Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2350INJECTION OF OCRELIZUMAB 1 MG16124.03125.10NANA1088Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9299INJECTION OF NIVOLUMAB 1 MG13114.8696.290NANA1089Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9306INJECTION OF PERTUZUMAB, 1 MG13122.4381.970NANA1090Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5119INJ RITUXIMAB-PVVR(RUXIENCE) BIOSIMILAR RUXIENCE 10 MG13180.7191.250NANA1091Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66982EXTRACAPSULAR CATARACT REMOVAL WITH COMPLEX TECHNIQUE AND DEVICES121059.790NANA1092Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88305LEVEL IV-SURGICAL PATHOLOGY GROSS/MICROSCOPIC EXAM301000.22NANA1093Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88321CONSULTATION AND REPORT OF SLIDES PREPARED ELSEWHERE101000NANA1094Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT45385COLONOSCOPY FLEXIBLE; WITH REMOVAL IF TUMOR/LESION BY SNARE TECHNIQUE101000NANA1095Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43239UPPER GATROINTESTIAL ENDOSCOPY WITH REMOVAL OF ONE OR MORE BIOPSIES101000NANA1096Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99202OFFICE/OUTPATIENT NEW PATIENT FOR MEDICAL DECISION MAKING of 15-29 MINUTES101074.310NANA1097Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ1650INJECTION OF ENOXAPARIN SODIUM, 10 MG101000NANA1098Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36415COLLECTION VENOUS BLOOD VENIPUNCTURE101000NANA1099Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11104PUNCH BIOPSY SKIN SINGLE LESION101000NANA1100Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80053COMPREHENSIVE METABOLIC PANEL101000NANA1101Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99203OFFICE/OUTPATIENT VISIT NEW PATIENT200.50313.770.07NANA1102Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT31050.991.7613.32NANA1103Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT44160.9816.25178.1NANA1104Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY20220.987.76136.31NANA1105Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235UPPER GI ENDO DX (SEP PROC)16860.9713.06159.87NANA1106Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS524960.9617.59126.64NANA1107Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN32300.9625.88156.24NANA1108Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS23670.9317.17250.08NANA1109Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10130130.9122.27228.84NANA1110Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES47920.8517.51227.26NANA1111Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE44300.8315.79189.24NANA1112Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76885ECHOGRAPHY OF INFANT HIPS, DYNAMIC18318.05110.96NANA1113Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73222MRI JOINT UPR EXTREM W/ DYE17318.8885.93NANA1114Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT91034GASTROESOPHAGEAL REFLUX TEST154122.14320.84NANA1115Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76642ULTRASOUND BREAST LIMITED15011.4337.94NANA1116Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93971BACK OFFICE DUPLEX SCAN, VEINS, UNILATERAL12218.5181.04NANA1117Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58300INSERT INTRAUTERINE DEVICE10816.32124.43NANA1118Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93922UPR/L XTREMITY ART 2 LEVE107113.3160.33NANA1119Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93880DUPLEX SCAN EXTRACRANIAL,BILAT10216.7269.06NANA1120Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78227HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ9013.3277.16NANA1121Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76882BACK OFFICE US, LIMITED, JOINT OR OTH NONVASC EXT, REAL TIME W/IMAG DOC83110.9319.69NANA1122Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81479UNLISTED MOLELCULAR PATHOLOGY PROCEDURE9400.0568.34658.76NANA1123Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT812ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, SCREENING COL53300.0243.07541.01NANA1124Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT813ANES COMBINED UPR/LWR GI ENDOSCOPIC PX, INTRO BOTH PROX/DISTAL DUODENUM18800.0229.52297.51NANA1125Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT740ANES UPR GI NDSC PX PROX DUO14200.0237.07682.69NANA1126Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97530THERA ACTVI DIRECT PAT CONTACT EA 15 MIN88000.0138.47291.57NANA1127Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT811ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, NOS48500.0127.82332.51NANA1128Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78815TUMORIMAGE PET/CT SKUL-THIGH45500.0133.73441.52NANA1129Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS524960017.59126.64NANA1130Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES47920017.51227.26NANA1131Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10130130022.27228.84NANA1132Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT1328118.22114.75NANA1133Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI JNT OF LWR EXTRE W/O54311.657.01NANA1134Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT ABD & PELV W/CONTRAST49712.3268.72NANA1135Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS115030.9913.4184.68NANA1136Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY8510.9917.13227.02NANA1137Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN5140.9917.29163.46NANA1138Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES7810.9818.93195.01NANA1139Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 1018430.9719.78222.38NANA1140Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES11760.9729.19126.32NANA1141Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE6430.9758.09226.44NANA1142Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN STEM W/O & W/DY43512.8291.38NANA1143Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73221MAGNETIC RESONANCE (EG, PROTON) JOINT28412.872.68NANA1144Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77080DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE26718.11202.78NANA1145Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71260COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/CONTRAST MATERIAL(S)26716.37124.48NANA1146Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN STEM W/O DYE250114.16189.13NANA1147Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI NECK SPINE W/O DYE23210.7890.43NANA1148Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378DIAGNOSTIC COLONOSCOPY21119.5371.09NANA1149Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70010MYLOGRAPHY POSTERIOR FOSSA COMPLETE19518.23249.34NANA1150Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11102TANGNTL BX SKIN SINGLE LE19111.62117.94NANA1151Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70486CT MAXILLOFACIAL W/O DYE18412.16102.29NANA1152Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ7330CULTURED CHONDROCYTES IMP300.671631.68NANA1153Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27279ARTHRODESIS, SACROID JNT, PERCUTANE OR MINIMAL INVASIVE W/ IMAGE GUIDE300.67427.26NANA1154Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT SIMPLE W/COMP500.437.28840.14NANA1155Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19318BREAST REDUCTION6300.0371.94450.34NANA1156Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77049MRI BREAST C-+ W/CAD BI33100.0222.68293.71NANA1157Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT731ANES UPR GI NDSC PX NOS20900.0232.07318.62NANA1158Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT811ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, NOS35400.0135.69334.59NANA1159Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT812ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, SCREENING COL24400.0145.43594.55NANA1160Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI LUMBAR SPINE W/O DYE4620014.08122.05NANA1161Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 1018430019.78222.38NANA1162Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS7210.320NANA1163Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNAPT IN THE HOME PER DIEM7018.3NANA1164Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES860.990.514.4NANA1165Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL720.974.827.2NANA1166Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS7490.9610.519.4NANA1167Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES4100.961.225.9NANA1168Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN1030.950.527.2NANA1169Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97810ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN3020.8939.6NANA1170Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98940CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS1650.7639.2NANA1171Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES680.6311.435.2NANA1172Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS7210.320NANA1173Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131PT IN THE HOME PER DIEM7018.3NANA1174Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST58111.315.3NANA1175Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040MEDICAL GENETICS COUNSELING EACH 30 MINUTES48129.1NANA1176Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST37117.316.5NANA1177Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN NO CONTRAST3610.116.1NANA1178Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST2911.58.5NANA1179Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES28110.736.1NANA1180Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97813ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN26132NANA1181Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74177CT ABD AND PELVIS W CONTRAST2617.128.7NANA1182Carrier E2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97533SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES200.550.5NANA1183Carrier E2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT10005FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION400.2553.2NANA1184Carrier E2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99202OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES6800.0311.435.2NANA1185Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A60100NANA1186Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66984Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation620.9430123NANA1187Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)540.9437127NANA1188Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple4810.913098NANA1189Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level860.912111NANA1190Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed750.911994NANA1191Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)3800.930980NANA1192Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft690.95194NANA1193Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99215Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.1190.6136113NANA1194Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter.1980.3134920NANA1195Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A6010.35NANA1196Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95800Slp Stdy Unatnd W/hrt Rate/o2 Sat/resp/slp Time2019.33NANA1197Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71260Computed Tomography, Thorax, Diagnostic; With Contrast Material(s)2016.26NANA1198Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37765Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions1714583NANA1199Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70491Ct,soft Tissue Neck;w/contrast Mat.11116NANA1200Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73722Mri, Any Joint Of Lower Extremity; With Contrast Material(s)91NANA1201Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157Mri Spinal Canal Wo & W Contrast; Thorac9125.41NANA1202Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72197Mri, Pelvis; W/o Contrast Then With Contrast And Further Sequences71NANA1203Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72156Mri Spinal Wo & W Contrast: Cerv7129NANA1204Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Psychotherapy, 60 Minutes With Patient6184NANA1205Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97110Tx,1 Area,15 Min,ea.vist;ther.exerc32012486NANA1206Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350Reconstruct Nipple/areolar Unil40172NANA1207Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15877Suction Assist Lipectomy Trunk10184NANA1208Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19303Mastectomy Simple Complete40172NANA1209Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex Op Male To Female301112NANA1210Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT54520Orchiectomy Simple Unilat10116120NANA1211Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15840Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)10197NANA1212Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15830Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy10196NANA1213Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63020Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical101118NANA1214Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93622Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (List separately in addition to code for primary procedure)101118NANA1215Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19325BREAST AUGMENTATION WITH IMPLANT1198.2NANA1216Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63030LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR111NANA1217Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33518CORONARY ARTERY BYP W/VEIN and ARTERY GRAFT 2 VEIN10NANA1218Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT52310CYSTO W/SIMPLE REMOVAL STONE and STENT1045.8NANA1219Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49329UNLISTED LAPAROSCOPIC PX ABD PERTONEUM AND OMENTUM100.6NANA1220Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20902BONE GRAFT ANY DONOR AREA MAJOR/LARGE10107.2NANA1221Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43621GSTRCT TOT W/ROUX-EN-Y RCNSTJ1016.7NANA1222Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21040EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL and CURT10107.2NANA1223Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49905OMENTAL FLAP INTRA-ABDOMINAL100.6NANA1224Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER1089.8NANA1225Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63030LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR111NANA1226Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE1198.2NANA1227Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325BREAST AUGMENTATION WITH IMPLANT1198.2NANA1228Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49905OMENTAL FLAP INTRA-ABDOMINAL100.6NANA1229Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21040EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL and CURT10107.2NANA1230Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11044DEBRIDEMENT BONE MUSCLE and /FASCIA 20 SQ CM OR LT10107.2NANA1231Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER1089.8NANA1232Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49329UNLISTED LAPAROSCOPIC PX ABD PERTONEUM AND OMENTUM100.6NANA1233Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31536LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE106NANA1234Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52310CYSTO W/SIMPLE REMOVAL STONE and STENT1045.8NANA1235Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home Sleep Test W/type Iii Portable Monitor30120.973.7NANA1236Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echocardiography, Transthoracic, Real-time W/ Image Documentation (2d), Includes M-mode Recording, When Performed49490.963.71NANA1237Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A24930.965NANA1238Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy Flexible, Transoral; With Biopsy, Single Or Multiple19830.9416.3547.47NANA1239Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Ct Abd & Pelvis W/o Contrast50420.931.715.72NANA1240Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic Resonance Imaging, Any Jnt-lowe42150.877.35NANA1241Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity22180.848.38NANA1242Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri,spin.canal,cerv;w/o Contrst Mat18080.8410.45NANA1243Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri,spin.canal,lumb;w/o Cntrst Matl31010.83189.720NANA1244Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTMSMPTPhysical Therapy111860.71139NANA1245Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically Aided Anter,cruciate Li15117281.43NANA1246Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75557Cardiac Mri For Morph5014NANA1247Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75572Ct Heart Contrast Eval Cardiac Structure&morph361NANA1248Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43242Egd Flex Transoral W/transendoscpic Us-guided Intramrl Or Transmrl Fine Ndl Aspiratn/biop(s) Esophag (incl Endoscpic Us Exam Of Esoph, Stom, &either Duod, Or Surg Altrd Stomac3311848NANA1249Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63035Laminotomy, With Decompression Of Nerve Root(s), Incl Partial Facetectomy, Formaninotomy And/or Excision Of Herniated Intervertabral Disc, Cervical Or Lumbar2812470.55NANA1250Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77790Supervise,handle,load Radioelement26115NANA1251Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77761Intracavitary Radioelement Application;s26115NANA1252Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77316Brachytherapy Isodose Plan; Simple (calculation[s] Made From 1 To 4 Sources, Or Remote Afterloading Brachytherapy, 1 Channel), Includes Basic Dosimetry Calculation(s)26115NANA1253Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38241Hematopoietic Progenitor Cell (hpc);autologous Transplantation25196105.88NANA1254Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19380Revision Of Reconstructed Breast (eg, Significant Removal Of Tissue, Re-advancement And/or Re-inset Of Flaps In Autologous Reconstruction Or Significant Capsular Revision23185.39NANA1255Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31267Nasal/sinus Endoscopy, Surgical, With Maxillary Antrostomy; With Removal Of Tissue From Maxillary Sinus1790143.277.29NANA1256Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63048Lam.,facetect,foraminot;ea Adtl.seg169017294.97NANA1257Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29888Arthroscopically Aided Anter,cruciate Li151017281.43NANA1258Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31253Nasal/sinus Endoscopy, Surgical With Ethmoidectomy; Total (anterior And Posterior), Incl Frontal Sinus Exploration, With Removal Of Tissue From Frontal Sinus, When Performed66012474.48NANA1259Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29874Arthroscop Knee W Remov Loose Body540174.47NANA1260Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31288Endoscopy,surg, Wtih Sphenoidotomy; W Sphenoid Sinus Tissue Removal490185.66NANA1261Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31259Nasal/sinus Endoscopy, Surgical With Ethmoidectomy; Total (anterior And Posterior), Including Sphenoidotomy, With Removal Of Tissue From The Sphenoid Sinus460178.21NANA1262Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31287Endoscopy, Surgical, With Sphenoidotomy44012498.71NANA1263Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27446Arthropls,knee,cond/plat;medor Lat440161.576.36NANA1264Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77386Intensity Modulated Radiation Treatment Delivery (imrt), Includes Guidance And Tracking, When Performed; Complex3901141.26NANA1265Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences1270.954.34NANA1266Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test/type III Porta1260.954.34NANA1267Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography1540.923.42NANA1268Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Computed tomography, abdomen and pelvis; without contrast material2060.97.4NANA1269Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material1530.866.07NANA1270Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material1170.8517.358.48NANA1271Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility3490.7722.4425.18NANA1272Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities1340.76161.2124.25NANA1273Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes3500.7522.4424.49NANA1274Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes2130.7419.14NANA1275Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74183Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences2214.1NANA1276Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed20129.441.6NANA1277Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)1516.52NANA1278Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic1514.56NANA1279Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64493Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level1410.17NANA1280Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64494Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)1210.18NANA1281Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73222Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)1019.42NANA1282Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft1017.16NANA1283Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58573Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)9116.7741.5232.3NANA1284Carrier I2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70496Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing912.29NANA1285Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63020Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical101115.68NANA1286Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63045Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical300.6753NANA1287Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT49568Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)200.5118.09NANA1288Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58353Endometrial ablation, thermal, without hysteroscopic guidance500.42.5865.95NANA1289Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29862Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum300.3335.73NANA1290Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29875Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)300.3338.49NANA1291Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29824Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)400.2528.01NANA1292Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT49560Repair initial incisional or ventral hernia; reducible400.2594.9NANA1293Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63030Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar600.170.197.39NANA1294Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29828Arthroscopy, shoulder, surgical; biceps tenodesis700.1455.21NANA1295Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography22750.962.9504NANA1296Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test/type III Porta15470.964.85NANA1297Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences13750.956.853.9NANA1298Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Computed tomography, abdomen and pelvis; without contrast material27890.932.845.07NANA1299Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material19550.870.216.06NANA1300Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material14730.850.296.88NANA1301Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes44100.7920.9830.65NANA1302Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility54910.7815.3331.52NANA1303Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes51700.7823.6431.49NANA1304Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities35300.7629.3432.36NANA1305Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report9110.317.8NANA1306Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70490Computed tomography, soft tissue neck; without contrast material4315.07NANA1307Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72142Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)3610.02NANA1308Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58552Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)30171.66NANA1309Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72147Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)2710NANA1310Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78472Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing1911.58NANA1311Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75572Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)1812.1819.6NANA1312Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29898Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive1810.270.0327.3NANA1313Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77371Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based1712.1660.6436.7NANA1314Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70487Computed tomography, maxillofacial area; with contrast material(s)1711.65NANA1315Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29887Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation10169.12NANA1316Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37216Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection101144.59NANA1317Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37215Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection101144.59NANA1318Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0075TTranscatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel101144.59NANA1319Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67961Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin400.5118.15NANA1320Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81215BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant200.560.51NANA1321Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43236Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance200.576.93NANA1322Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99152Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older500.479.28NANA1323Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21121Genioplasty; sliding osteotomy, single piece500.476.91NANA1324Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67917Repair of ectropion; extensive (eg, tarsal strip operations)600.33108.64NANA1325Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21141Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft600.33189.47NANA1326Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58660Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)300.3350.22NANA1327Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27412Autologous chondrocyte implantation, knee300.3371.84NANA1328Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20999Unlisted procedure, musculoskeletal system, general300.3364.07NANA1329Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, Complete with Doppler6661NANA1330Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98941Chiropractic Care4320.993.5NANA1331Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98943Chiropractic Care2200.992.75213.9NANA1332Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Residential Adult1160.9712.961.19NANA1333Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260CT THORAX WITH CONTRAST2470.96NANA1334Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI Brain WITH & WITHOUT CONTRAST3480.95NANA1335Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT ABDOMEN & PELVIS WITH CONTRAST4000.94NANA1336Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI LOWER EXTREMITY JOINT WITHOUT CONTRAST3880.89NANA1337Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE WITHOUT CONTRAST2750.81NANA1338Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI UPPER EXTREMITY JOINT WITHOUT CONTRAST2040.78NANA1339Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAPsychological and Neuropsychological Test Administration54119.82NANA1340Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA98942Chiropractic Care35148NANA1341Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA98940Chiropractic Care32148NANA1342Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ29101.38NANA1343Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Behavior Identification Assessments2715.97NANA1344Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH IOP Adolescent2610.92NANA1345Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Residential Eating Disorder Adult2512.9924.64NANA1346Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Direct Care Codes2512.63NANA1347Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA87660IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ23101.46NANA1348Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA87480IADNA CANDIDA SPECIES DIRECT PROBE TQ23101.46NANA1349Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ5716.52NANA1350Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98940Chiropractic Care53184NANA1351Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD760.9915.27.75NANA1352Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE730.9918.167.47NANA1353Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98941Chiropractic Care4020.9884NANA1354Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98943Chiropractic Care2060.9784NANA1355Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479UNLISTED MOLELCULAR PATHOLOGY PROCEDURE540.966.0635NANA1356Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81420FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS480.6531.54NANA1357Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND690.5962.07NANA1358Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND560.5959.9835NANA1359Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ5716.52NANA1360Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239EGD TRANSORAL BIOPSY SINGLE/MULTIPLE4711.317.38NANA1361Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC3611.1311.25NANA1362Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45384COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS3013.78NANA1363Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81374HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH1911.06NANA1364Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM1610.10.58NANA1365Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64493NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL13121.36NANA1366Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81220CFTR GENE ANALYSIS COMMON VARIANTS1310.13NANA1367Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY12120.166.11NANA1368Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C10110.58NANA1369Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM4011.8100.2NANA1370Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT390.971.85217.85NANA1371Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS460.960.5278.26NANA1372Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES190.953.79990.32NANA1373Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES190.89-195.791784.84NANA1374Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A250.88-148.8744.96NANA1375Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES230.87-161.741562.09NANA1376Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT200.653.6102NANA1377Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT260.622.77216.92NANA1378Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION280.612.57294.86NANA1379Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM4011.8100.2NANA1380Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT390.971.85217.85NANA1381Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS460.960.5278.26NANA1382Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES190.953.79990.32NANA1383Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES190.89-195.791784.84NANA1384Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A250.88-148.8744.96NANA1385Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES230.87-161.741562.09NANA1386Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT200.653.6102NANA1387Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT260.622.77216.92NANA1388Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION280.612.57294.86NANA1389Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services13115.518.2NANA1390Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97810Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient3146.5NANA1391Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction2150.5NANA1392Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete2150.5NANA1393Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan21276.9NANA1394Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97811Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)211.1168NANA1395Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours2129.5NANA1396Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes21276.9393.6NANA1397Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes21276.9466.29NANA1398Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes21276.9576NANA1399Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual170.8223.7NANA1400Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem80.756.8NANA1401Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853Group psychotherapy (other than of a multiple-family group)202.922.1NANA1402Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15877Suction assisted lipectomy; trunk2050.5461NANA1403Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services13115.518.2NANA1404Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97810Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient3146.5NANA1405Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction2150.5NANA1406Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes21276.9NANA1407Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97811Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)211.1NANA1408Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete2150.5NANA1409Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan21276.9NANA1410Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours2129.5NANA1411Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes21276.9NANA1412Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes21276.9NANA1413Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy41108.25NANA1414Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS0201Substance Abuse Partial Hospitalization Program4124NANA1415Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124NANA1416Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program3124NANA1417Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)2124.5NANA1418Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization1124NANA1419Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy41108.25NANA1420Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0201Substance Abuse Partial Hospitalization Program4124NANA1421Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124NANA1422Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program3124NANA1423Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)2124.5NANA1424Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization1124NANA1425Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY WITH PATIENT AND FAMILY 60 MINUTES1010156.670.11NANA1426Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96101PSYHCOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT910187.72192.35NANA1427Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM7127.2158.190NANA1428Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0004BEHAVIORAL HEALTH COUNSELING AND THERAPY PER 15 MIN61052.620NANA1429Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY WITH PAIENT AND FAMILY 45 MINUTES41104.4321.630.25NANA1430Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY; SINGLE SEIZURE31080.110NANA1431Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015INTENSIVE OUTPATIENT ALCOHOL AND/OR DRUG SERVICES ->=3HOURS A DAY/3DAYS A WEEK210118.370NANA1432Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES150.93095.290NANA1433Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY WITH PATIENT WITH EVALUTATION/MANAGEMENT LASTING 45 MIN290.90104.220.16NANA1434Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES PER DIEM50.80136.090NANA1435Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY WITH PATIENT AND FAMILY 60 MINUTES1010156.670.11NANA1436Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96101PSYHCOLOGICAL TESTINGG PER HOUR FACE TO FACE TIME WITH PATIENT910187.72192.35NANA1437Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM7127.2158.190NANA1438Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0004BEHAVIORAL HEALTH COUNSELING AND THERAPY PER 15 MIN61052.620NANA1439Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY WITH PAIENT AND FAMILY 45 MINUTES41104.4321.630.25NANA1440Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY; SINGLE SEIZURE31080.110NANA1441Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015INTENSIVE OUTPATIENT ALCOHOL AND/OR DRUG SERVICES ->=3HOURS A DAY/3DAYS A WEEK210118.370NANA1442Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT110289.850NANA1443Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING FACE TO FACE TIME WITH PATIENT FOR 1ST HOUR OF TREATMENT110198.10NANA1444Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESSMENT110145.130NANA1445Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT141290.9946.32193.87NANA1446Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT81090.9951.597.9NANA1447Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS45440.9932.33199.89NANA1448Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY12100.9974.93113.09NANA1449Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS2060.98176.38NANA1450Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH1650.98130.21NANA1451Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR3230.95147.68248.79NANA1452Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES3010.91125.29585.12NANA1453Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR1750.8765.84442.04NANA1454Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS2140.7953.58648.05NANA1455Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96150ASSESS HLTH/BEHAVE INIT161129.94NANA1456Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99492INIT PSYCHIATRIC COLLABORATIVE CARE MGMT, FIRST 70 MINS/FIRST CAL MONTH1311047.05NANA1457Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97803MED NUTRIT THRPY REASSESS PER 15 MIN71392.21NANA1458Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN7191.2NANA1459Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT41637.48NANA1460Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING BILLED PER HR BY PHD2145.61NANA1461Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95819EEG AWAKE & ASLEEP INCLUDE HYPERVENTILATION &/OR21137.98NANA1462Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96127BRIEF EMOTION/BEHAVIOR ASSES, W/SCORING AND DOC, PER STNDARD INSTRUMNT211061.95NANA1463Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96125COGNITIVE TEST BY HC PRO21355.82NANA1464Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0362TBHV ID SUPRT ASSMT EA 1521811.09NANA1465Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD10194.45NANA1466Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ8999ORAL PRESCRIPTION DRUG CHEMO200.5765.04NANA1467Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT14400.0248.06462.93NANA1468Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS21400.0153.58648.05NANA1469Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT141290046.32193.87NANA1470Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90834PSYCHOTHERAPY 45 MIN PATIENT81090051.597.9NANA1471Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS45440032.33199.89NANA1472Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT832123.30319625190.66NANA1473Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT646137.9005566889.01NANA1474Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS453133.43685336193.13NANA1475Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY110173.56166692113.9NANA1476Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES38124.4785427585.84NANA1477Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT151887.26NANA1478Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR350.9416.85305825192.17NANA1479Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR820.9344.40416865452.8NANA1480Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS680.8427.44527833277.07NANA1481Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT470.7471.99097414349.24NANA1482Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY110173.56166692113.9NANA1483Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES38124.4785427585.84NANA1484Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT151887.26NANA1485Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH141200.31NANA1486Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2014SKILLS TRAIN AND DEV, 15 MIN111693.3NANA1487Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10911448.03NANA1488Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS41194.34NANA1489Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY31395.82NANA1490Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES31651.14NANA1491Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS3113.84NANA1492Carrier D2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT4700.0471.99097414349.24NANA1493Carrier D2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR8200.0144.40416865452.80NANA1494Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN51124.5216NANA1495Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS39121.2NANA1496Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION34119.2NANA1497Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN20115.5600NANA1498Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS17121.5NANA1499Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN16131.1NANA1500Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN14133.6NANA1501Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES3050.9925.9NANA1502Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION7350.9726.3NANA1503Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES330.9726.5NANA1504Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN51124.5NANA1505Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS39121.2NANA1506Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION34119.2NANA1507Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN20115.5NANA1508Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS17121.5NANA1509Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN16131.1NANA1510Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN14133.6NANA1511Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE1317.3NANA1512Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY13153.5NANA1513Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97152BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN10119.3NANA1514Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem160.882372NANA1515Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1000.82466NANA1516Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem400.81968NANA1517Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management200.8355NANA1518Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session280.7910660NANA1519Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management230.781062NANA1520Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education410.713465NANA1521Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Psychotherapy, 60 minutes with patient220.45329118.3NANA1522Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96136Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes120.424290NANA1523Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853Group psychotherapy (other than of a multiple-family group)120.332376NANA1524Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes1113595NANA1525Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes1012384NANA1526Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan911692NANA1527Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0032Mental health service plan development by nonphysician6185NANA1528Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2019Therapeutic behavioral services, per 15 minutes6185NANA1529Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes5135108NANA1530Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90836Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)1198NANA1531Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90840Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service)11209NANA1532Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90686Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use1198NANA1533Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)1175NANA1534Carrier F2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837Psychotherapy, 60 minutes with patient2200.093291NANA1535Carrier F2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours10000.012466NANA1536Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0297LOW DOSE CT SCAN FOR LUNG CANCER SCREENING530.8525.255.7NANA1537Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY40.7525.2212.7NANA1538Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG70.7148.6112NANA1539Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M70.7148.6112NANA1540Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19325BREAST AUGMENTATION WITH IMPLANT70.7142.5NANA1541Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV and MN50.648.6107.6NANA1542Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE70.5764NANA1543Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION90.4480.5NANA1544Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT80307DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE80.3872.5NANA1545Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN5016.3NANA1546Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81381HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP310NANA1547Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0004BEHAVIORAL HEALTH CNSL AND THERAPY PER 15 MINUTES2177.7NANA1548Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96164HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN2177.7NANA1549Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035MENTAL HEALTH PARTIAL HOSP TX LT 24 HOURS2129.725.6NANA1550Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92523EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION21175.3NANA1551Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96165HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN2177.7NANA1552Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350NIPPLE/AREOLA RECONSTRUCTION21110.7NANA1553Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR21203.5NANA1554Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380ELECTROLYSIS EPILATION EACH 30 MINUTES1199.8NANA1555Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL1123.5NANA1556Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96132NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR101192.4NANA1557Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT92522EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE101136.7NANA1558Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT92610EVAL ORAL AND PHARYNGEAL SWLNG FUNCJ101136.7NANA1559Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT92523EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION200.5175.3NANA1560Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR200.5203.5NANA1561Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTH0035MENTAL HEALTH PARTIAL HOSP TX LT 24 HOURS200.529.725.6NANA1562Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96138PSYCL/NRPSYCL TST TECH 2 Plus TST 1ST 30 MIN300.33203.5NANA1563Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96121NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR300.33203.5NANA1564Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96139PSYCL/NRPSYCL TST TECH 2 Plus TST EA ADDL 30 MIN300.33203.5NANA1565Carrier G2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR300.33203.5NANA1566Carrier H2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Including Cortical Mapping, Motor Threshold Determination, Delivery And Mgmt1530.9167NANA1567Carrier H2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (tms) Treatment; Subsequent Motor Threshold Re-determination With Delivery And Management1550.864876NANA1568Carrier H2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Initial, Including Cortical Mapping, Motor Threshold Determination, Subsequent Delivery And Mgmt.1700.584877146.3NANA1569Carrier H2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Including Cortical Mapping, Motor Threshold Determination, Delivery And Mgmt1530.9167.34NANA1570Carrier H2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (tms) Treatment; Subsequent Motor Threshold Re-determination With Delivery And Management1550.864876.46NANA1571Carrier H2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Initial, Including Cortical Mapping, Motor Threshold Determination, Subsequent Delivery And Mgmt.1700.584877.34NANA1572Carrier H2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Including Cortical Mapping, Motor Threshold Determination, Delivery And Mgmt15300.3367.34NANA1573Carrier H2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (tms) Treatment; Subsequent Motor Threshold Re-determination With Delivery And Management15500.224876.46NANA1574Carrier H2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90870Electroconvulsive therapy (includes necessary monitoring)500.21792NANA1575Carrier H2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Initial, Including Cortical Mapping, Motor Threshold Determination, Subsequent Delivery And Mgmt.17000.14877.34NANA1576Carrier H2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS0201Partial hospitalization services, less than 24 hours, per diem4400.026568NANA1577Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours10120.6423.2NANA1578Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management8137.06NANA1579Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session8137.06NANA1580Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management8137.06NANA1581Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem6157.31NANA1582Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services70.8619.54NANA1583Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual120.830.6135.61NANA1584Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes20.572.67NANA1585Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes20.520.86NANA1586Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT81229Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities20.575.45NANA1587Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes20.520.86NANA1588Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes20.520.86NANA1589Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility20.572.02352NANA1590Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours10120.6423.2NANA1591Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session8137.061.6NANA1592Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management8137.06NANA1593Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management8137.06NANA1594Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem6157.31NANA1595Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences110NANA1596Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions111.68NANA1597Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes110.3815.5NANA1598Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81244FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; characterization of alleles (eg, expanded size and promoter methylation status)1175.4523NANA1599Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete1146.2923.5NANA1600Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81321PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis1175.45NANA1601Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities110.3820.8NANA1602Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81323PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant1175.458.7NANA1603Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan1120.8610.6NANA1604Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction1146.2921.1NANA1605Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81243FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles1175.45NANA1606Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material11024NANA1607Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450Computed tomography, head or brain; without contrast material11010.6NANA1608Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92522Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);11182.15NANA1609Carrier I2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours100020.6423.2NANA1610Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services2350.9928.4417.34NANA1611Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem1050.9242.57NANA1612Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours960.9235.9460.64NANA1613Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management660.8522.3845.15NANA1614Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management570.8125.3938.91NANA1615Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session760.7919.4943.53NANA1616Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes480.7574.9NANA1617Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual2480.7457.33NANA1618Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes490.7473.43NANA1619Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92523Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)590.6870.31NANA1620Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences51018.9NANA1621Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81229Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities5116.24NANA1622Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450Computed tomography, head or brain; without contrast material514.2319.3NANA1623Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81243FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles4120.3NANA1624Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97814Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)416.39NANA1625Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97813Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient416.39NANA1626Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes31126.07NANA1627Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions310.84NANA1628Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0283Electrical Stimulation (Unattended), To One Or More Areas For Indicati3135.970.1NANA1629Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81416Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)2184.87NANA1630Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)2172.2815.3NANA1631Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97124Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)210.0511.1NANA1632Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63650Percutaneous implantation of neurostimulator electrode array, epidural21130.1928.7NANA1633Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81415Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis2184.87NANA1634Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64493Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level21211.34NANA1635Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0362TBehavior identification supporting assessment, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.21107.44NANA1636Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64494Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)21211.34NANA1637Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97164Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family.21185.21NANA1638Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT17380Electrolysis epilation, each 30 minutes300.33126.07NANA1639Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97152Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes1100.09103.21NANA1640Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97154Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes1200.0845.83NANA1641Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session7600.0319.4943.53NANA1642Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes4600.0277.58NANA1643Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan4600.0265.18NANA1644Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes4800.0274.9NANA1645Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes4900.0273.43NANA1646Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management5700.0225.3938.91NANA1647Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management6600.0222.3845.15NANA1648Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAPsychological and Neuropsychological Test Administration54119.82NANA1649Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD IOP Adult1040.990.071.69NANA1650Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Partial Adult1030.991.3815.18NANA1651Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH IOP Adult930.999.08NANA1652Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Partial Adult900.980.42.4835NANA1653Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Detox Residential Adult540.980.664.09NANA1654Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Residential Adult440.981.9214NANA1655Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Residential Adult1160.9712.961.19NANA1656Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Partial Eating Disorder Adult320.976.912.18NANA1657Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAPsychological Testing670.9325.38NANA1658Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAPsychological and Neuropsychological Test Administration54119.82NANA1659Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Behavior Identification Assessments2715.97NANA1660Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH IOP Adolescent2610.92NANA1661Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Residential Eating Disorder Adult2512.9924.64NANA1662Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Direct Care Codes2512.63NANA1663Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH IOP Eating Disorder Adult2417.84NANA1664Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Qualified Health Professional Services2412.73NANA1665Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Residential Adolescent2310.056.66NANA1666Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Partial Eating Disorder Adolescent14122.6715.1NANA1667Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASUD Residential Adolescent1310.0424.09NANA1668Carrier K2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMH Partial Adolescent2000.9540.45NANA1669Carrier K2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANATranscranial Magnetic Stimulation (TMS)1700.5944.03NANA1670Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2311POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXEDMOUNTING HARDWARE217202NANA1671Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED217202NANA1672Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0861POWER WHEELCHAIR, GROUP 3 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS217202NANA1673Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPC92700UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE114801NANA1674Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0951HEEL LOOP/HOLDER, WITH OR WITHOUT ANKLE STRAP, EACH114801NANA1675Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0953WHEELCHAIR ACCESSORY, LATERAL THIGH OR KNEE SUPPORT, ANY TYPE INCLUDING FIXED MOUNTING HARDWARE, EACH114801NANA1676Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, PREFABRICATED, INCLUDING FIXED HARDWARE, EACH114801NANA1677Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH119601NANA1678Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1012WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, CENTER MOUNT POWER ELEVATING LEG REST/PLATFORM, COMPLETE SYSTEM, ANY TYPE, EACH114801NANA1679Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1007WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION30.675603NANA1680Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2311POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXEDMOUNTING HARDWARE217202NANA1681Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED217202NANA1682Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861POWER WHEELCHAIR, GROUP 3 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS217202NANA1683Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPC92700UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE114801NANA1684Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0951HEEL LOOP/HOLDER, WITH OR WITHOUT ANKLE STRAP, EACH114801NANA1685Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0953WHEELCHAIR ACCESSORY, LATERAL THIGH OR KNEE SUPPORT, ANY TYPE INCLUDING FIXED MOUNTING HARDWARE, EACH114801NANA1686Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, PREFABRICATED, INCLUDING FIXED HARDWARE, EACH114801NANA1687Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH119601NANA1688Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1012WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, CENTER MOUNT POWER ELEVATING LEG REST/PLATFORM, COMPLETE SYSTEM, ANY TYPE, EACH114801NANA1689Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1007WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION30.675603NANA1690Carrier M2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2361POWER WHEELCHAIR ACCESSORY, 22NF SEALED LEAD ACID BATTERY, EACH, (E.G. GEL CELL, ABSORBED GLASSMAT)1019601NANA1691Carrier M2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1007WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION1002401NANA1692Carrier M2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2300WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM, ANY TYPE1004801NANA1693Carrier M2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2321POWER WHEELCHAIR ACCESSORY, HAND CONTROL INTERFACE, REMOTE JOYSTICK, NONPROPORTIONAL, INCLUDING ALL RELATED ELECTRONICS, MECHANICAL STOP SWITCH, AND FIXED MOUNTING HARDWARE1009601NANA1694Carrier M2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0841POWER WHEELCHAIR, GROUP 2 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS1002401NANA1695Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9312INJECTION, RITUXIMAB, 10 MG12142012NANA1696Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; INITIATION OF PROLONGED CHEMOTHERAPY INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF A PORTABLE OR IMPLANTABLE PUMP200.9532.4020NANA1697Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)140.9396014NANA1698Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)90.787209NANA1699Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE AND SEGMENT; LUMBAR100.667.2010NANA1700Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR120.58196012NANA1701Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)130.5442.5013NANA1702Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE220.541.5022NANA1703Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)140.534.3015NANA1704Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO130.4660.9013NANA1705Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9312INJECTION, RITUXIMAB, 10 MG12142012NANA1706Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9070CYCLOPHOSPHAMIDE, 100 MG917209NANA1707Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9181INJECTION, ETOPOSIDE, 10 MG915609NANA1708Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614SPINE FUSION, EXTRA SEGMENT814508NANA1709Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9000INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG816308NANA1710Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; INITIATION OF PROLONGED CHEMOTHERAPY INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF A PORTABLE OR IMPLANTABLE PUMP200.9532.4020NANA1711Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43775LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)140.9396014NANA1712Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20936AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)130.5442.5013NANA1713Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE220.541.5022NANA1714Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20930ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)140.534.3014NANA1715Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22853INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE1100.6458.9011NANA1716Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO700.5761.707NANA1717Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20930ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)700.4351.407NANA1718Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20936AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)600.57206NANA1719Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR500.681.605NANA1720Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE AND SEGMENT; LUMBAR400.7510804NANA1721Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DESKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR300.337203NANA1722Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22612Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)300.3314403NANA1723Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22216REVISE, EXTRA SPINE SEGMENT200.515602NANA1724Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22612ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)200.52402NANA1725Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRMHResidential Mental Health8198NANA1726Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalMENMental Health2102NANA1727Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalREHRehabilitation210.96.921NANA1728Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse50.814.45NANA1729Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalDAADetoxification20.5242NANA1730Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRMHResidential Mental Health81908NANA1731Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalMENMental Health21002NANA1732Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalREHRehabilitation210.96.9021NANA1733Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse50.814.405NANA1734Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalDAADetoxification20.52402NANA1735Carrier M2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalREHRehabilitation2001202NANA1736Carrier M2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalDAADetoxification1004801NANA1737Carrier M2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalRSAResidential Substance Abuse100001NANA1738Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION101100101NANA1739Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE5818.7058NANA1740Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)670.9930.8067NANA1741Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89258CRYOPRESERVATION; EMBRYO680.9730.4068NANA1742Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION730.7578.2073NANA1743Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318BREAST REDUCTION750.7322.4075NANA1744Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)870.5554.9087NANA1745Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE820.3753.3082NANA1746Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89291BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS490.0452.9049NANA1747Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89290BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS480.0454048NANA1748Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION101100101NANA1749Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE5818.7058NANA1750Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED4419.8044NANA1751Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)670.9930.8067NANA1752Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89258CRYOPRESERVATION; EMBRYO680.9730.4068NANA1753Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58322ARTIFICIAL INSEMINATION; INTRA-UTERINE310.937.9031NANA1754Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION730.7578.2073NANA1755Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318BREAST REDUCTION750.7322.4075NANA1756Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)870.5554.9087NANA1757Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE820.3753.3082NANA1758Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE5200.0236052NANA1759Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89291BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS470055.1047NANA1760Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89290BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS460056.3046NANA1761Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)3900.0517.8039NANA1762Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19318BREAST REDUCTION2000.234.8020NANA1763Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION1800.0636018NANA1764Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30410RHINOPLASTY, PRIMARY; COMPLETE, EXTERNAL PARTS INCLUDING BONY PYRAMID, LATERAL AND ALAR CARTILAGES, AND/OR ELEVATION OF NASAL TIP8004508NANA1765Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31256NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY;700.4378.907NANA1766Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15776PUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN 15 PUNCH GRAFTS6001206NANA1767Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21139REDUCTION FOREHEAD; CONTOURING ONLY CONTOURING AND SET BACK OF ANTERIOR FRONTAL SINUS WALL6003206NANA1768Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS50114.4050NANA1769Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT48135.5048NANA1770Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM20110.8020NANA1771Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES181766.7018NANA1772Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES181766.7018NANA1773Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES181766.7018NANA1774Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A17121.2017NANA1775Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT280.68105.4028NANA1776Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT380.66135.2038NANA1777Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION380.66135.2038NANA1778Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS50114.4050NANA1779Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT48135.5048NANA1780Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM20110.8020NANA1781Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES181766.7018NANA1782Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES181766.7018NANA1783Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES181766.7018NANA1784Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A17121.2017NANA1785Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT280.68105.4028NANA1786Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT380.66135.2038NANA1787Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION380.66135.2038NANA1788Carrier M2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT1300236.3013NANA1789Carrier M2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION1300236.3013NANA1790Carrier M2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT90018409NANA1791Carrier M2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97152BEHAVIOR IDENTIFICATIONSUPPORTING ASSESSMENT, ADMINISTERED BY ONE TECHNICIAN U NDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH THE PATIENT, EACH 15 MINUTES1007201NANA1792Carrier M2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97158GROUP ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH MULTIPLE PATIENTS, EACH 15 MINUTES100302401NANA1793Carrier A2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin41108.24013424NANA1794Carrier A2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10160.53944441NANA1795Carrier A2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10160.53944441NANA1796Carrier A2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin41108.24013424NANA1797Carrier A2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10160.53944441NANA1798Carrier A2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10160.53944441NANA1799Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)918.7027469139NANA1800Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified21105.93138892NANA1801Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]1960.971.340782313196NANA1802Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)140.8619.0450595214NANA1803Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal30.3362.685679913NANA1804Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi110.18182.935585311NANA1805Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu400.004386324NANA1806Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B200.0102777792NANA1807Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0950Tray200.0107291662NANA1808Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware200.0104133342NANA1809Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods2012.028396252NANA1810Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0960Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware200.0101509732NANA1811Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER2017.217592.8708333311NANA1812Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)918.7027469139NANA1813Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified21105.93138892NANA1814Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]1960.971.340782313196NANA1815Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)140.8619.0450595214NANA1816Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal30.3362.685679913NANA1817Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi110.18182.935585311NANA1818Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu400.004386324NANA1819Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B200.0102777792NANA1820Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0950Tray200.0107291662NANA1821Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware200.0104133342NANA1822Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods2012.028396252NANA1823Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0960Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware200.0101509732NANA1824Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER2017.217592.8708333311NANA1825Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)7152.773943837NANA1826Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)6167.903275816NANA1827Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar5170.27620265NANA1828Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar5170.460729865NANA1829Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)80.8866.65170528NANA1830Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump10041.1819590710NANA1831Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9250Methotrexate Sodium Inj6034.90618656NANA1832Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)5013.926455225NANA1833Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)500.0207155565NANA1834Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS2068Breast DIEP flag reconstruct5013.926341675NANA1835Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33929Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)113.798888891NANA1836Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33976Insertion of ventricular assist device; extracorporeal, biventricular113.798888891NANA1837Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33927Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy113.798888891NANA1838Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33945Heart transplant, with or without recipient cardiectomy113.798888891NANA1839Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33979Insertion of ventricular assist device, implantable intracorporeal, single ventricle113.798888891NANA1840Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach110.0044444451NANA1841Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)7152.773943837NANA1842Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)6167.903275816NANA1843Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar5170.27620265NANA1844Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar5170.460729865NANA1845Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)4176.094735874NANA1846Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)2157.42303992NANA1847Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)2157.42303992NANA1848Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))2112.813868472NANA1849Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)2157.42303992NANA1850Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical1122.435352781NANA1851Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22800Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments1125.190593611NANA1852Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar1144.734119441NANA1853Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27132Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft1136.800075831NANA1854Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63252Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar110.0305555561NANA1855Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)1171.779444441NANA1856Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33340Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation111.7852777781NANA1857Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22630Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar1125.190593611NANA1858Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20931Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)1116.892009171NANA1859Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric411.2341666661.45965305513NANA1860Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder130.9262.6014766913NANA1861Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services10102.21666671NANA1862Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA1863Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric411.2341666661.45965305513NANA1864Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder130.9262.6014766913NANA1865Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services10102.21666671NANA1866Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA1867Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation1450.949.725153257145NANA1868Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2510.936.9877404487202511NANA1869Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis2260.9312.2330689226NANA1870Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr2110.920.1086111128.6666181871210NANA1871Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI, any joint of upper extremity; wo co1140.870.15305555511.9721320767211131NANA1872Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1590.8412.34567115159NANA1873Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes4740.7140.1486780640.976925553471NANA1874Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility4960.740.1486780637.512929043493NANA1875Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes2460.6930.69431239.3489813243NANA1876Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities2580.6816.5127629243.9106771762422561NANA1877Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft2218.48630940722NANA1878Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64494Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)1810.03179659518NANA1879Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1711.82465686317NANA1880Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74174ct angio abd&pelv w/o&w/dye1617.78590277816NANA1881Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70552Contrast MRI of brain15111.7094074115NANA1882Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng1410.01448412714NANA1883Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr14112.1179960314NANA1884Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29882Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)13141.8107006713NANA1885Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73720MRI, lower extremity other than joint; w1315.17068376113NANA1886Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl1210.000069412NANA1887Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction12134.010876512NANA1888Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70496CTA, head, w/o cntrst flwd by cntrst1217.94228632512NANA1889Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64636Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)12132.9939050412NANA1890Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine15900.0212.34567115159NANA1891Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64483Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level7100.040.43715361127.52914773170NANA1892Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27096Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed3400.0628.7597605934NANA1893Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64635Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint1500.0728.1935554615NANA1894Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar1000.10.04416666725.8061552419NANA1895Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63030Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar800.130.195765222109.366673726NANA1896Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)500.229.849551815NANA1897Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12118.8224726312NANA1898Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5113.010694445NANA1899Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes80.75101.50878238NANA1900Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities40.7546.180559934NANA1901Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-310.749.08145161331NANA1902Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session60.6734.47368696NANA1903Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management60.6734.441481486NANA1904Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management60.6734.47368696NANA1905Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual180.3365.46100057648181NANA1906Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92523Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)40.25125.25051764NANA1907Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834Psychotherapy, 45 minutes with patient4013.7121111111.8915456513NANA1908Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853Group psychotherapy (other than of a multiple-family group)4013.712110284.34525898213NANA1909Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77385Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; simple110.0102777771NANA1910Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12118.8224726312NANA1911Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5113.010694445NANA1912Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131Physical therapy, in the home, per diem2123.161532922NANA1913Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97124Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)211.4393579172NANA1914Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences2144.526944442NANA1915Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain2102NANA1916Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77301Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications310.01027777760.3120833312NANA1917Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81229Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities110.0094444461NANA1918Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97032Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes110.1788888891NANA1919Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77386Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex1123.920277781NANA1920Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97026Application of a modality to 1 or more areas; infrared110.1788888891NANA1921Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77338Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan210.01027777723.9202777811NANA1922Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG6015RADIATION TX DELIVERY IMRT210.01055555596.7038888911NANA1923Carrier A2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT71271CT THORAX LW DOSE LNG CA SCR C-3100.039.08145161331NANA1924Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXT AMB INFUSN PUMP INSULIN719656160NANA1925Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT21036020NANA1926Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8619COCH IMP EXT PROC/CONTR RPLC11096010NANA1927Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8685IMPLT NROSTM PLS GEN SNG REC11024010NANA1928Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11024010NANA1929Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE110168010NANA1930Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44145PARTIAL REMOVAL OF COLON1101NANA1931Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15734MUSCLE-SKIN GRAFT TRUNK1101NANA1932Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21085PREPARE FACE/ORAL PROSTHESIS11241NANA1933Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58543LSH UTERUS ABOVE 250 G1101NANA1934Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTOMY1101NANA1935Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32667THORACOSCOPY W/W RESECT ADDL1101NANA1936Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61304OPEN SKULL FOR EXPLORATION11241NANA1937Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47379LAPAROSCOPE PROCEDURE LIVER11481NANA1938Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58954TAH RAD DEBULK/LYMPH REMOVE1101NANA1939Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHRD CMBN 1NTRSPC LUMBAR50.6915NANA1940Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible0NANA1941Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44145PARTIAL REMOVAL OF COLON1101NANA1942Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734MUSCLE-SKIN GRAFT TRUNK1101NANA1943Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21085PREPARE FACE/ORAL PROSTHESIS11241NANA1944Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58543LSH UTERUS ABOVE 250 G1101NANA1945Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTOMY1101NANA1946Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32667THORACOSCOPY W/W RESECT ADDL1101NANA1947Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61304OPEN SKULL FOR EXPLORATION11241NANA1948Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47379LAPAROSCOPE PROCEDURE LIVER11481NANA1949Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58954TAH RAD DEBULK/LYMPH REMOVE1101NANA1950Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047LAM FACETEC & FORAMOT LUMBAR11241NANA1951Carrier N2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASubstance Abuse Residential31030NANA1952Carrier N2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMental Health Inpatient11010NANA1953Carrier N2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASubstance Abuse Residential31030NANA1954Carrier N2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMental Health Inpatient11010NANA1955Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA15132143120NANA1956Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95806SLEEP STUDY UNATT&RESP EFFT410.97607.60410NANA1957Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY530.943120167.12510NANA1958Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM280.929057.40280NANA1959Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE220.909038.20220NANA1960Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA400.8524481390NANA1961Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64999NERVOUS SYSTEM SURGERY110.8180113.50110NANA1962Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM190.789073.30190NANA1963Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI (eg, proton) ANY JOINT OF LOWER EXTREMITY160.750690160NANA1964Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ1745INFLIXIMAB NOT BIOSIMIL 10MG140.429090.90140NANA1965Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA15132143120NANA1966Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0299HHS/HOSPICE OF RN EA 15 MIN1010120100NANA1967Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95800SLP STDY UNATTENDED9100090NANA1968Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION9102.7090NANA1969Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5121INJ. AVSOLA, 10 MG7100070NANA1970Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS RF 1ST VEIN61072060NANA1971Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION610400060NANA1972Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0399HOME SLEEP TEST/TYPE 3 PORTA6100060NANA1973Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0122INJ MENOTROPINS 75 IU6100600NANA1974Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0126INJ FOLLITROPIN ALFA 75 IU6100600NANA1975Carrier N2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ1557GAMMAPLEX INJECTION300.3324010NANA1976Carrier N2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67904REPAIR EYELID DEFECT10124010NANA1977Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)4124040NANA1978Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124030NANA1979Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization2124020NANA1980Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program2124020NANA1981Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy1169.25010NANA1982Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)4124040NANA1983Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124030NANA1984Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization2124020NANA1985Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program2124020NANA1986Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy1169.25010NANA1987Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM11187.5401100NANA1988Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY830.9448.6106.0802810NANA1989Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY210.972.6285.7301200NANA1990Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN90.8979.040090NANA1991Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING290.86119.7300290NANA1992Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME120.5157.4100120NANA1993Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY70.29137.890070NANA1994Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM11187.5401100NANA1995Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY830.9448.6106.0802810NANA1996Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY210.972.6285.7301200NANA1997Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN90.8979.040090NANA1998Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING290.86119.7300290NANA1999Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME120.5157.4100120NANA2000Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY70.29137.890070NANA2001Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP20121.48148.931190NANA2002Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE121120.870120NANA2003Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR9129.6682.34450NANA2004Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE4910.9843.82101.6434870NANA2005Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR1520.9711.975.63131380NANA2006Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP300.9760.75123.582280NANA2007Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP190.9569.8685.642170NANA2008Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS720.8898.80.040721NANA2009Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT TYPE USED NON-INVASIVE170.8221.4121.071160NANA2010Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108OTHER ACCESSORY100.8143.610100NANA2011Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR9129.6682.340450NANA2012Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399DURABLE MEDICAL EQUPMENT MISCELLANEOUS51112.210050NANA2013Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4222SUPPLIES EXTERNAL DRUG INFUSION PUMP PER CASSETTE/BAG41152.560040NANA2014Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510SPEECH GENERATING DEVICE/SYNTHIZED SPEECH, PERMITTING MULTIPLE METHODS OF MESSAGE FORMULATION31101.370030NANA2015Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0007EXTRA HEAVY-DUTY WHEELCHAIR2184.450020NANA2016Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4221SUPPLIES-MAINTAINCE DRUG INFUSION CATHETERS PER WEEK1169.450010NANA2017Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCV5260HEARING AID, DIGITAL, BINAURAL, ITE11112.250010NANA2018Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2359POWER WHEELCHAIR ACCESSORY, GROUP 34 SEALED LEAD ACID BATTERY11193.220010NANA2019Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4425OSTOMY POUCH, DRAINABLE USE ON BARRIAR WITH NON-LOCKING FLANGE W NON-LOCKING FLANGE-2 PIECE SYSTEM11153.350010NANA2020Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9279MONITOR FEATURE/DEVICE, STAND-ALONE OR INTEGRAT, ANY TYPE, NOT OTHERWISE CLASSIFIED11124.40010NANA2021Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0466HOME VENT TYPE USED NON-INVASIVE1700.0621.4121.0701160NANA2022Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0486ORAL DEVICE/APPLIANCE TO REDUCE UP/AIRWAY COLLAPSIBILITY ADJUSTABLE ORTHOTIC300.330248.670030NANA2023Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0652PNEUMATIC COMPRESS SEGMENTAL W ITH GRADIENT PRESS300.330392.910030NANA2024Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0668SEGMENTAL PNEUMATIC-USE W/COMPRESSOR FULL ARM200.50408.820020NANA2025Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPORSCOPY REMOVAL OF PART OF THE COLON1112.1897.9801100NANA2026Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECTOMY9186.770090NANA2027Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT TO BONE DURING SPINAL SURGERY160.9445.4400160NANA2028Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840INSTRUMENTATION INSERTED TO CORRECT A SPINAL SPACE120.9232.8400120NANA2029Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614SPINAL FUSION TO JOIN TWO VERTEBRAE90.8958.920090NANA2030Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearcPT22853METALLIC MESH BETWEEN VERTEBRAE170.8844.2700170NANA2031Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT MATERIAL ATTACHED TO SPINE160.8847.9100160NANA2032Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK70.8661.720070NANA2033Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION90.7851.610090NANA2034Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047SINGLE VERTEBRAE LAMINECTOMY SURGERY70.7149.160070NANA2035Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPAROSCOPIC PROCEDURE DONE DURING A PARTIAL COLECTOMY612.18132.150150NANA2036Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9070CYCLOPHOSPHAMIDE 100MG41125.570040NANA2037Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52332INSPECTION OF INSIDE OF BLADDER WITH A SCOPE1165.90010NANA2038Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0538TT-LYMPHOCYTES FROZEN FOR TRANSPORT1129.180010NANA2039Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0539TLABORTATORY RECEIPT AND PREP OF T-LYMPHOCYTES1129.180010NANA2040Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49255OMENTECTOMY/EPIPLOECTOMY-RESECTION OMENTUM1142.680010NANA2041Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0569TREPAIR OF MITRAL VLAVE DEFECT WITH PROTHESIS1195.570010NANA2042Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58548LAPAROSCOPIC REMOVAL OF UTERUS, FALLOPIAN TUBES, OVARIES, AND LIGAMENTS1171.630010NANA2043Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0570TREPAIR OF TRICUSPIC VALVE WITH PROSTHIC DEVICE1195.80010NANA2044Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61781INTRACRANIAL SCAN PERFORMED DURING INTERCRANIAL SURGERY1119.480100NANA2045Carrier B2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22857LUMBAR ARTIFICAL DISKECTOMY101059.230010NANA2046Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC410206.780040NANA2047Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126SEMI-PRIVATE DETOXIFICATION BED INPATIENT2102.450020NANA2048Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY110540010NANA2049Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY430.95026.1500410NANA2050Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC410206.780040NANA2051Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126SEMI-PRIVATE DETOXIFICATION BED INPATIENT2102.450020NANA2052Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY110540010NANA2053Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY430.95026.1500410NANA2054Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCQ5101INJ FILGRASTIM G-CSF BIOSIMULATOR61115.656.9120390NANA2055Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue551SKILLED NURSE VISIT IN HOME1480.9964.88101.9101370NANA2056Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ3489ZOLEDRONIC ACID 1MG640.9713.6652.4618450NANA2057Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483ANESTHETIC AGEN AND/OR STERIOD INJECTION FOR TRANSFORAMINAL EPIDURAL INJECTION INTO A SINGLE LEVEL790.9143.40790NANA2058Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE1630.871.41152.1711620NANA2059Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD1800.7823.73153.5111790NANA2060Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION,ONABOTULINUMTOXINA1130.7626.15146.4641050NANA2061Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN2010.6370.64124.250.05161814NANA2062Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-7630.4175.290630NANA2063Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-14640.39175.260640NANA2064Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5118INJECTION BEVACIZUMAB-BVCR BIOSIMILAR 10 MILLIGRAM (ZIRABEV)26124.0682.6205200NANA2065Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9299INJECTION NIVOLUMAB 1 MILLIGRAM1914.06113.8706130NANA2066Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9022INJECTION ATEZOLIZUMAB 10 MILLIGRAM11110.0176.680380NANA2067Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81208BCR/ABL1 GENETIC TEST FOR CHROMOSOME 2231176.890030NANA2068Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81257HBA1/HBA2 GENETIC TEST FOR ALPHA THALASSEMIA3169.440030NANA2069Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2182INJECTION MEPOLIZUMAB 1MILLIGRAM21129.420020NANA2070Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81256HFE GENE (HEMOCHROMATOSIS GENE) TEST FOR CHANGES2197.740020NANA2071Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ0694INJECTION CEFOXITIN SODIUM 1 GRAM1122.230010NANA2072Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81261IGH GENETIC TEST FOR LYMPHOID NEOPLASMS11117.750010NANA2073Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0491DIALYSIS ACUTE KIDNEY WITHOUT END STAGE RENAL DISEASE115.650100NANA2074Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21209OSTEOPLASTY FACIAL BONES; REDUCTION1010270.06010NANA2075Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77067SCREENING MAMMOGRAPHY3010000NANA2076Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99213OFFICE/OUTPATIENT VISIT ESTABLISHED1010000NANA2077Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT83605TEST FOR AMOUNTS OF LACTATE1010000NANA2078Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88304LEVEL III-SURGICAL PATH GROSS/MICROSCOPIC EXAM1010000NANA2079Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23350INJECTION PROCEDURE TO THE SHOULDER JOINT1010000NANA2080Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77065DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED1010000NANA2081Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11104PUNCH BIOPSY SKIN SINGLE LESION10101.17001NANA2082Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80053COMPREHENSIVE METABOLIC PANEL10100.07001NANA2083Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHO THERAPY FOR LESS THAN 60 MINUTES10100.04003NANA2084Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT1010204.0100100NANA2085Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM410113.310030NANA2086Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM310159.130030NANA2087Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201PARTIAL HOSPITALZTION SERVICES <24 HR-PER DIEM21074.530020NANA2088Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES21031.890020NANA2089Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY210445.40020NANA2090Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES;METHADONE ADMINISTRATION/SERVICE110200.570010NANA2091Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY SESSION UNDER 60 MINUTES11098.120010NANA2092Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015INTENSIVE OUTPATIENT PROGRAM FOR CHEMICAL DEPENDENCY TREATMENT110136.870010NANA2093Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY240.920176.9100240NANA2094Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT1010204.0100100NANA2095Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPT PSYCH SERV PER DIEM410113.310030NANA2096Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM310159.130030NANA2097Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY210445.40020NANA2098Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0201PARTIAL HOSPITALZTION SERVICES <24 HR-PER DIEM21074.530020NANA2099Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES21031.890020NANA2100Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES;METHADONE ADMINISTRATION/SERVICE110200.570010NANA2101Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVALUATION SERVICES PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL FOR THE FIRST HOUR110236.250010NANA2102Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY SESSION UNDER 60 MINUTES11098.120010NANA2103Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015INTENSIVE OUTPATIENT PROGRAM FOR CHEMICAL DEPENDENCY TREATMENT110136.870010NANA2104Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE4730.99225341162NANA2105Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN7180.97612015703NANA2106Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS21600.9655191611999NANA2107Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG1280.9616435573NANA2108Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD1170.957111170NANA2109Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE2600.9316477253NANA2110Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV850.9293472560NANA2111Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D6290.859699373256NANA2112Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1860.839198522164NANA2113Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES8270.801783426401NANA2114Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95250GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL73117370NANA2115Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5501DIABETIC CUSTOM MOLDED SHOE23147023NANA2116Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11042DEBRIDE SKIN & SUBQ TISSUE161028115NANA2117Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11721DEBRIDE NAIL(S) ANY METHOD(S) 6+917509NANA2118Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN10102037NANA2119Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92014COMPREHENSIVE EYE EXAM ESTABLISHED PT 1+ VISITS9192827NANA2120Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93924NON-INVASIVE STUDY LE ARTERY POST T9103927NANA2121Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE VISIT E&M NEW PT MODERATE MDM, 45-59 MINS81254226NANA2122Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92134OCT MACULAR/RETINA W/INTERP & REPORT; UNIL/BILAT1211030102NANA2123Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762MISC SERVICES22113220NANA2124Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES82700.009783426401NANA2125Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D62900.006699373256NANA2126Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERN AMBUL INSULIN INFUS PUMP18600.022198522164NANA2127Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND5590.99870559NANA2128Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE21910.995130210388NANA2129Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR6580.99431441617NANA2130Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT6320.9891129623NANA2131Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE36910.984282093482NANA2132Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 025390.974527226313NANA2133Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT6900.9731028354336NANA2134Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL12520.957228669583NANA2135Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH5740.953440290284NANA2136Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE47460.91644314853261NANA2137Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3260POST-OP SHOE CANVAS2681074264NANA2138Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1846KO W ADJ FLEX/EXT ROTAT MOLD1081071296NANA2139Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0849TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE751120273NANA2140Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL7520REPAIR PROSTH DEV LABOR PER 15 MIN721545963NANA2141Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0156SEAT ATTACHMENT, WALKER11112265259NANA2142Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4386WALKING BOOT, PREFAB, NONPNEUMATIC461333145NANA2143Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0484OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEV, NONELEC, ANY TYPE, EACH4711321037NANA2144Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0100CANES OF ANY MATERIAL4810131830NANA2145Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4338INDWELLING CATH LATEX11711610215NANA2146Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0165COMMODE CHAIR STATIONARY4211292814NANA2147Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0739REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS21500.0051187501650NANA2148Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA6549GRADIENT COMPRESSION STOCKING/SLEEVE NOS16500.0123489111540NANA2149Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0766ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE2900.06922117.55240NANA2150Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5700REPLACE SOCKET BEL KNEE PT MODEL2000.05131331190NANA2151Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5673ADDTN TO LOW EXTRMTY BELOW/ABOVE KNEE,CUSTOM FAB,USE W/LOCKING MECH1900.0530801180NANA2152Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4105IN-LINE CARTRIDGE CONTAINING DIGESTIVE ENZYME(S) ENTERAL FEEDING; EA200.574.5020NANA2153Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1028WHEELCHAIR ACCESS, MANUAL SWINGAWAY, MULT POWER OPTION, POSITION ACCESS200311.5020NANA2154Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21089UNLISTED MAXILLOFACIAL PROSTH PROC10198010NANA2155Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0848PWR WHEELCHAIR, GRP 3 STNDRD, SLING/SOLID SEAT/BACK,CAP UP TO/INCL 300 LBS101306010NANA2156Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4427OSTOMY POUCH, DRAINABLE; USE ON BARRIER W LOCKING10174100NANA2157Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue367SURGERY72177072NANA2158Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1200.9834296114NANA2159Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD137310.97612371368843NANA2160Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY340.9713201717NANA2161Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV970.9497421384NANA2162Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y330.90972033NANA2163Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST510.882424843NANA2164Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU260.65423160224NANA2165Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS310.6452676724NANA2166Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD1740.48913531731NANA2167Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue367SURGERY72177072NANA2168Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663THORACOSCOPY SURG W/ LOBECTOMY TOTAL/SEGMEN10103319NANA2169Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE TO FEMALE916709NANA2170Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33427VAL-PLASTY MITRAL VAL W/BYPASS RAD CONS W/WO RING81708NANA2171Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE10132237NANA2172Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT9111827NANA2173Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST14128104NANA2174Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58210RAD ABD HYST W/ BILAT PEL LYMPHADENECTOMY81104244NANA2175Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH711312861NANA2176Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762MISC SERVICES2310230NANA2177Carrier C2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120ROOM AND BOARD1373100123713688430NANA2178Carrier C2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT50220NEPHREC W/ PART URETERECT OPEN W/ RIB RESECT1200.08311372100NANA2179Carrier C2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD17400.023135317310NANA2180Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD2390.992512390NANA2181Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV3680.972423671NANA2182Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3780.968253780NANA2183Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD8670.96711908634NANA2184Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD2390.992512390NANA2185Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV3680.972423671NANA2186Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3780.968253780NANA2187Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD8670.96711908634NANA2188Carrier C2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124ROOM AND BOARD86700.00211908634NANA2189Carrier C2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue900OTHER THERAPY SERV36800.0052423671NANA2190Carrier C2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD37800.003253780NANA2191Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAMISC SERVICES63400.988114563391NANA2192Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT76380CT SCAN LIMITED OR LOCALIZED F/U STUDY24580.9783176911767NANA2193Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT108870.97721149510392NANA2194Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY32630.9734174782785NANA2195Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235UPPER GI ENDO DX (SEP PROC)31800.9692124072773NANA2196Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE114980.9592525911239NANA2197Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS1082370.957191193596302NANA2198Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN28840.9498271382746NANA2199Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES143140.909102474013574NANA2200Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS34720.88514445492923NANA2201Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76885ECHOGRAPHY OF INFANT HIPS, DYNAMIC21711056210207NANA2202Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9098HOME PHOTOTHERAPY VISIT77132077NANA2203Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96160ADM OF HEALTH RISK ASSESS PATIENT FOCUS W/SCORE76114076NANA2204Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19083BX BREAST W/ DEVICE IMAGING PERC; FIRST LESION, W/ US GUIDE8713192166NANA2205Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11102TANGENTIAL BIOPSY OF SKIN; FIRST LESION751112966NANA2206Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57420COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT;53107449NANA2207Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31622BRONCHOSCOPY RIGID/FLEX W/WO CELL WASH (SEP PROC)5618351838NANA2208Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20670REM IMPLANT SUPERFICIAL (SEP PROC)5011261337NANA2209Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58301REM IUD COMPLICATED W/DEVICE (NOT HEMOSTAT)451621837NANA2210Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT65855TRABECULOPLASTY LASER SURG 1+ SESSIONS4819221533NANA2211Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT53854TRANSURETHRAL DESTRUCT PROSTAT TISSUE;BY RADIOFRQ WATER THERMOTHERPY700.286166070NANA2212Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15830EXCISION, EXCESS SKIN & SUBQU TISSUE, ABDOMEN600.33325121150NANA2213Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT42145PALATOPHARYNGOPLASTY500.4164050NANA2214Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43499UNLISTED PROC ESOPHAGUS300.333133030NANA2215Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99201.276REF PLASTIC SURGERY200.563020NANA2216Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ7050NORMAL SALINE SOL INFUS 250 ML200.5242020NANA2217Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT, SIMPLE W/COMP500.428309410NANA2218Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT66183INSERTION ANT SEG AQUEOUS DEVICE W/O EXTRAOCULAR RES EXTERNAL APPROACH200.548289110NANA2219Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT85390FIBRINOLYSINS OR COAGULOPATHY101140100NANA2220Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99421ONLINE DIGITAL EM SVC, EST PT, FOR UP TO 7 DAYS, CUMULATIVE TIME; 5-10 MINS10125100NANA2221Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT12370.99371941233NANA2222Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS1240.99247571123NANA2223Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS41880.9911864464142NANA2224Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY10670.9944532131054NANA2225Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR4010.98329445396NANA2226Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT208640.981303922020644NANA2227Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR1760.926501059167NANA2228Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES6310.8594110649582NANA2229Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT1670.832850167NANA2230Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES1290.791110813126NANA2231Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT361111101135NANA2232Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT12126012NANA2233Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY 30 MIN PATIENT71113216NANA2234Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97803MED NUTRIT THRPY REASSESS PER 15 MIN611506NANA2235Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN5111005NANA2236Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214.101REF MENTAL HEALTH INTERNAL (FOR MH PROVIDERS ONLY)3122003NANA2237Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96137PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;ADDL 30 MINS2115902NANA2238Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96158HEALTH BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; INITIAL 30 MINS21202NANA2239Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90807IND PSYCHOTHERAPY OFFICE 45-50 MIN W/ E & M1128101NANA2240Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD11010NANA2241Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT2086400.0013039220206440NANA2242Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS418800.00118644641420NANA2243Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR17600.0065010591670NANA2244Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES12900.0311108231260NANA2245Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97153ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS4900.02302011480NANA2246Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 102400.0422570240NANA2247Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99215OFFICE VISIT E&M EST PT, HIGH MDM, 40-54 MINS200.5123113110NANA2248Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS5660.99151638528NANA2249Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE880.9893597315NANA2250Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN1650.9883228157NANA2251Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE730.986138172NANA2252Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG640.9849281549NANA2253Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD440.97714440NANA2254Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG530.92515471340NANA2255Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D2930.8028114163130NANA2256Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP850.74129129877NANA2257Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES3910.7061297212179NANA2258Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV261338521NANA2259Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99202OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS161124214NANA2260Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95249GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING10127010NANA2261Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenueNAOTHER THERAPY SERV10102319NANA2262Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10914609NANA2263Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95250GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL711707NANA2264Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11719TRIMMING NONDYSTROPHIC NAILS ANY NUMBER614906NANA2265Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5513FOR DIAB ONLY MX DNSITY INSRT CSTM MOLD CSTM EA612906NANA2266Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA12146193NANA2267Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenueNAMISC SERVICES17116170NANA2268Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES39100.0112972121790NANA2269Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D29300.0181141631300NANA2270Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERN AMBUL INSULIN INFUS PUMP8500.047291298770NANA2271Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP2350.996150235NANA2272Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE7310.99514569239NANA2273Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR3640.9920173361NANA2274Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT3350.991150335NANA2275Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE8770.98622128849NANA2276Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND2810.986210281NANA2277Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 022050.98153888117NANA2278Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT1960.983359799NANA2279Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL2930.966233138155NANA2280Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE18430.963403571486NANA2281Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1833WARRIOR WRAP WITH HINGES/FLEX STOP971013196NANA2282Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW911116289NANA2283Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1830KO IMMOBILIZER CANVAS LONGIT78120078NANA2284Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1812KNEE ORTHOSIS, ELAST W/JOINTS, PREFAB,OFF-THE-SHELF44117044NANA2285Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN451540441NANA2286Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4387WALKING BOOT, PREFAB, NONPNEUMATIC33112033NANA2287Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE4913272227NANA2288Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTV2624POLISHING ARTIFICAL EYE24141024NANA2289Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB22129022NANA2290Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR6913295514NANA2291Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0601CPAP DEVICE184300.00134035714860NANA2292Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0114CRUTCHES METAL UNDERARM PAIR36400.00301733610NANA2293Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0739REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS5200.0191911914380NANA2294Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0760OSTEOGEN U/S STIMLTOR3100.032241497240NANA2295Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0652PNEUMATIC COMPRESS SEGMNT W GRAD2100.0481141881200NANA2296Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0823POWER WC, GROUP 2 STD, CAPTAINS, PT WT UP TO/INCLUDE 300 LBS300.333138030NANA2297Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE8000GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT INCL ALL ACCESSORIES & COMP101100010NANA2298Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV231078320NANA2299Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue367SURGERY12183012NANA2300Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP1211232210NANA2301Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY13151649NANA2302Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD59420.9691772590636NANA2303Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV310.968122823NANA2304Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU250.88187025NANA2305Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y220.86472022NANA2306Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAP SLEEVE GASTRECTOMY220.546109022NANA2307Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD720.36127720NANA2308Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV231179320NANA2309Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue367SURGERY12183012NANA2310Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP1211232210NANA2311Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY13151649NANA2312Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST11174129NANA2313Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST1110338NANA2314Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO9131718NANA2315Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32650THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA1011237NANA2316Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364BREAST RECONSTRUCTION; WITH FREE FLAP911010027NANA2317Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE,LEVL I9112336NANA2318Carrier D2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120ROOM AND BOARD59420017725906360NANA2319Carrier D2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775LAP SLEEVE GASTRECTOMY2200.0911090220NANA2320Carrier D2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD7200.042277200NANA2321Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912OTHER THERAPY SERV111001NANA2322Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV2370.987132370NANA2323Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD4450.98494450NANA2324Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD1460.98281460NANA2325Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3730.979513730NANA2326Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912OTHER THERAPY SERV111001NANA2327Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV2370.987132370NANA2328Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD4450.98494450NANA2329Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD1460.98281460NANA2330Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3730.979513730NANA2331Carrier D2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124ROOM AND BOARD44500.00294450NANA2332Carrier D2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD37300.003513730NANA2333Carrier D2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue900OTHER THERAPY SERV23700.004132370NANA2334Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT76380CT SCAN LIMITED OR LOCALIZED F/U STUDY13690.995213437932NANA2335Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT21940.9937132221972NANA2336Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY18620.993143151547NANA2337Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS243180.988519230322015NANA2338Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE17600.9833411381722NANA2339Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue762MISC SERVICES27610.9821527610NANA2340Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES26790.9816151142565NANA2341Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS6630.97763190573NANA2342Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL6510.8361247136515NANA2343Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72158MRI LUMBAR W/WO CONTRST SPINE8840.39626120149735NANA2344Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93241EXT ECG RECORD >48 HRS UP TO 7 DAYS BY CONT RHYTHM, INCL REC/SCAN W/INTERP & REP14211229133NANA2345Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT94010SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW12117119112NANA2346Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CAT REM W/ INSERT LENS PROSTHESIS; W/O ECP127113116111NANA2347Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17311MOHS HD, NCK, HND, FEET, GEN 1ST STGE UP TO 5 BLCK134121434100NANA2348Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93797OPEN CARDIAC REHAB W/O CONT EKG MONITORING84113122777NANA2349Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93242EXT ECG RECORD >48 HRS UP TO 7 DAYS BY CONT RHYTHM RECORDING/STORAGE7111136566NANA2350Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT26540REPAIR COLLAT LIGAMENT METACARPOPHALANGEAL/IP JNT7519231956NANA2351Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93270EVENT MONITOR - HOOKUP RECORD & DISCON ONLY8513133154NANA2352Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97597DEBRIDEMENT, OPEN WOUND, ASSESSMENT, ONGOING CARE, PER SESSION, FIRST 20 SQ CM OR LESS7012212248NANA2353Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77412RAD TX DELIVERY CUSTOM BLOCK 5 MEV9013164644NANA2354Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y400.25171040NANA2355Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT, SIMPLE W/COMP400.2598131130NANA2356Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29916ARTHROSCOPY HIP W/LABRAL REPAIR400.25477130NANA2357Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT53854TRANSURETHRAL DESTRUCT PROSTAT TISSUE;BY RADIOFRQ WATER THERMOTHERPY300.33387030NANA2358Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11606EXC MALIG LES TRUNK ARMS/LEGS >4.0 CM400.253582220NANA2359Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67908REP BLEPHAROPTOSIS CONJU200.5202020NANA2360Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77280THERAPEUTIC RADIOLOGY FIELD SIMPLE300.3332142210NANA2361Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43210EGD, FLEX, TRNSORAL; W EG FUNDOPLASTY, PARTIAL /COMPLETE, INC DUODENOSCOSPY101105010NANA2362Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27299UNLISTED PROC PELVIS/HIP JNT101125010NANA2363Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88381MICRODISSECTION; MANUAL10144100NANA2364Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY1531260153NANA2365Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT2480.99260248NANA2366Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS6410.98813488633NANA2367Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT27940.987825382756NANA2368Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR640.953165262NANA2369Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR810.92613199477NANA2370Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS230.913139122NANA2371Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES260.88596026NANA2372Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES1200.8834412712108NANA2373Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT770.83186077NANA2374Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY1531260153NANA2375Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE131109013NANA2376Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES131106013NANA2377Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS711407NANA2378Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806.102REF MENTAL HEALTH EXTERNAL516305NANA2379Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT216502NANA2380Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY 30 MIN PATIENT1131701NANA2381Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR1130801NANA2382Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96138PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS117401NANA2383Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96159HEALTH BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; EA ADDL 15 MINS11801NANA2384Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT2794008253827560NANA2385Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR8100.025131994770NANA2386Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT7700.039860770NANA2387Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS9480PSYCH SVC INTENSIVE OUTPT600.1671358150NANA2388Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG2082VISIT FOR EVAL/MGMT EST PT REQ SUPERVISOIN MD, UP TO 56 MG OF ESKETAMINE NASAL, SELF ADMIM500.274050NANA2389Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL37193.855.3136NANA2390Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21197.121NANA2391Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN191114.619NANA2392Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D6128.96NANA2393Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA6257TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS1123.91NANA2394Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE1580.9627.7158NANA2395Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS360.8135.433.7333NANA2396Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous510.3327.451NANA2397Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL37193.855.3136NANA2398Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21197.121NANA2399Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN191114.619NANA2400Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D6128.96NANA2401Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6257TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS1123.91NANA2402Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE1580.9627.7158NANA2403Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS360.8135.433.7333NANA2404Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous510.3327.451NANA2405Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR7819.58.774.311661NANA2406Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM3410.626.522.54282NANA2407Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP ANY TYPE4211622.9339NANA2408Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S1610.990.414.513.211564NANA2409Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR1910.985.826.817.52214524NANA2410Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR340.9735.70322NANA2411Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE780.9752.133.24434NANA2412Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION840.9445.752.6822NANA2413Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1410.923.624.436141252NANA2414Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA6530GRADIENT COMPRESSION STK BELW KNEE 18-30 MMHG EA380.63117.735.3299NANA2415Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR7819.58.774.311661NANA2416Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0691UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS26120.130.9251NANA2417Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7005NONDISPOSABLE NEBULIZER SET2210.7210.11201NANA2418Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM3410.626.522.54282NANA2419Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP261313.9283212NANA2420Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8015EXT BREASTPROSTHESIS GARMENT18162.720.2144NANA2421Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP ANY TYPE4211622.9339NANA2422Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1846KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM191291.857.9217NANA2423Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6212FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA26165.726NANA2424Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0693UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL21119.921NANA2425Carrier E2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA6530GRADIENT COMPRESSION STK BELW KNEE 18-30 MMHG EA3700.0392.337NANA2426Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCD0303D0303NON-TRAUMATIC BRAIN INJURY WITH MOTOR >26.15 & MOTOR <35.05.,COMORBIDITY IN TIER 31101NANA2427Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT3120.235.112NANA2428Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99223INITIAL HOSPITAL CARE/DAY 70 MINUTES210.12NANA2429Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCD0106D0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,COMORBIDITY IN TIER 31125.21NANA2430Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCD0102D0102STROKE WITH MOTOR >44.45 & MOTOR <51.05 & COGNITIVE >18.5.,COMORBIDITY IN TIER 31101NANA2431Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCC0302C0302NON-TRAUMATIC BRAIN INJURY WITH MOTOR >35.05 & MOTOR <41.05.,COMORBIDITY IN TIER 21101NANA2432Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA0502A0502NON-TRAUMATIC SPINAL CORD INJURY WITH MOTOR >40.15 & MOTOR <51.35.,WITHOUT COMORBI110.11NANA2433Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA0302AMBULANCE BASIC EMERGENY ALL1101NANA2434Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA0301A0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,WITHOUT COMORBIDITIES1121NANA2435Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA0106A0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,WITHOUT COMORBIDITIES1152.11NANA2436Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCD0303D0303NON-TRAUMATIC BRAIN INJURY WITH MOTOR >26.15 & MOTOR <35.05.,COMORBIDITY IN TIER 31101NANA2437Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT3120.235.112NANA2438Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99223INITIAL HOSPITAL CARE/DAY 70 MINUTES210.12NANA2439Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCD0106D0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,COMORBIDITY IN TIER 31125.21NANA2440Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCD0102D0102STROKE WITH MOTOR >44.45 & MOTOR <51.05 & COGNITIVE >18.5.,COMORBIDITY IN TIER 31101NANA2441Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCC0302C0302NON-TRAUMATIC BRAIN INJURY WITH MOTOR >35.05 & MOTOR <41.05.,COMORBIDITY IN TIER 21101NANA2442Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA0502A0502NON-TRAUMATIC SPINAL CORD INJURY WITH MOTOR >40.15 & MOTOR <51.35.,WITHOUT COMORBI110.11NANA2443Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA0302AMBULANCE BASIC EMERGENY ALL1101NANA2444Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA0301A0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,WITHOUT COMORBIDITIES1121NANA2445Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA0106A0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,WITHOUT COMORBIDITIES1152.11NANA2446Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<1192.61NANA2447Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT21126REFERRAL PORTLAND, REFERRALS EXTERNAL1130.91NANA2448Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION3119.253.421NANA2449Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION9180.249.154NANA2450Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV7145.57NANA2451Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC11139.411NANA2452Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC48114.28.22424NANA2453Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP290.93127.575.262.41622NANA2454Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES50.832.258.532NANA2455Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<1192.61NANA2456Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21126REFERRAL PORTLAND, REFERRALS EXTERNAL1130.91NANA2457Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION3119.253.421NANA2458Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION9180.249.154NANA2459Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV7145.57NANA2460Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC11139.411NANA2461Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC48114.28.22424NANA2462Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP290.93127.575.262.41622NANA2463Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES50.832.258.532NANA2464Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ101121.63.8992NANA2465Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES43315.639.235.2839926NANA2466Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS990.990.534.231.93924NANA2467Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD1200.9827.8101191NANA2468Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS9190.983.438.626.81386640NANA2469Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98940CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS1940.9745.1194NANA2470Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97810ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN3720.9642.613711NANA2471Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN1030.9635.243.8985NANA2472Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES950.967.937.520.34856NANA2473Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99211OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP1230.93.236.62441181NANA2474Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97110THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES7610.835.44.93721NANA2475Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN NO CONTRAST3016.344.727.317121NANA2476Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ101121.63.8992NANA2477Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST3616.338.60.42862NANA2478Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74177CT ABD AND PELVIS W CONTRAST28113.450.271918NANA2479Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131PT IN THE HOME PER DIEM5919.359NANA2480Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT87635IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ36124.936NANA2481Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97813ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN35143.535NANA2482Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98941CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS28144.928NANA2483Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST60110.535.93723NANA2484Carrier E2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97810ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN37200.0142.613711NANA2485Carrier E2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21126REFERRAL PORTLAND, REFERRALS EXTERNAL3700.032.673.256.73295NANA2486Carrier E2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99202OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES6200.0246.943.5359NANA2487Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES31156.769.8301NANA2488Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES27135.80.8261NANA2489Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS25143.96.4241NANA2490Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE21145.26.3201NANA2491Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION35139.9141520NANA2492Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN22137.622NANA2493Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN19164.719NANA2494Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES4590.9950.944.64563NANA2495Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION13220.9839.861.3131111NANA2496Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN520.9862.452NANA2497Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES31156.769.8301NANA2498Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES27135.80.8261NANA2499Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS25143.96.4241NANA2500Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE21145.26.3201NANA2501Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE8147.579.762NANA2502Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION35139.9141520NANA2503Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN22137.622NANA2504Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN19164.719NANA2505Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN18144.718NANA2506Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0005ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN6139.36NANA2507Carrier E2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION132200.00139.861.3131111NANA2508Carrier F2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips280.615.7632.61622NANA2509Carrier F2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips280.615.7632.61622NANA2510Carrier F2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANATest Strips28005.7632.61622NANA2511Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment7111207NANA2512Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, 1 unit = 1 day supply330.9119122429NANA2513Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1852Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf100.9133010NANA2514Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with interstitial continuous glucose monitoring system180.8936114315NANA2515Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis stimulator, electrical, noninvasive, other than spinal applications80.8611108NANA2516Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infusion set for external insulin pump, nonneedle cannula type100.82615928NANA2517Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin130.692815058NANA2518Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous80.635215317NANA2519Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0603Breast pump, electric (AC and/or DC), any type130.15186013NANA2520Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous positive airway pressure (CPAP) device80.1311008NANA2521Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment7111207NANA2522Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1846Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated61238815NANA2523Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section5111605NANA2524Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1970Ankle-foot orthosis (AFO), plastic with ankle joint, custom fabricated516310714NANA2525Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6550Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories4111904NANA2526Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each4111904NANA2527Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable4111804NANA2528Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766Electrical stimulation device used for cancer treatment, includes all accessories, any type415010413NANA2529Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL0650Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf416311213NANA2530Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1851Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf4110804NANA2531Carrier F2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2999Lower extremity orthoses, not otherwise specified200.59902NANA2532Carrier F2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2755Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only200.59902NANA2533Carrier F2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCB4152Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit10112201NANA2534Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)110.822494110NANA2535Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;140.712554311NANA2536Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)270.72461324NANA2537Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN2440.67306557187NANA2538Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)180.672557216NANA2539Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar150.672348312NANA2540Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)120.672556210NANA2541Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar140.642465212NANA2542Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)160.632555214NANA2543Carrier F2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)170.592534314NANA2544Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);81334635NANA2545Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663Thoracoscopy, surgical; with lobectomy (single lobe)61178524NANA2546Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22214Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar51259614NANA2547Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33427Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring51426714NANA2548Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20937Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure)417611013NANA2549Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61781Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)4168913NANA2550Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)319503NANA2551Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)312910512NANA2552Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22216Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)31256412NANA2553Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22600Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment31249612NANA2554Carrier F2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43848Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)2018602NANA2555Carrier F2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT49255Omentectomy, epiploectomy, resection of omentum (separate procedure)20152711NANA2556Carrier F2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT49205Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter101510NANA2557Carrier F2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT44005Enterolysis (freeing of intestinal adhesion) (separate procedure)101510NANA2558Carrier F2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96549Unlisted chemotherapy procedure101610NANA2559Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0018Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem112610NANA2560Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5380.953311175463NANA2561Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)4710.943511270401NANA2562Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level1400.913411318122NANA2563Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92250Fundus photography with interpretation and report1340.93310926108NANA2564Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66984Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation1380.89341124098NANA2565Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed830.8930105974NANA2566Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft1140.82281191599NANA2567Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation40.252140NANA2568Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours2026511NANA2569Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric10501NANA2570Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27096Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed57136110552NANA2571Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36471Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg291102029NANA2572Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43238Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)23130105419NANA2573Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT69990Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)20147115119NANA2574Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36482Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated14198014NANA2575Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64633Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint12175120111NANA2576Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66982Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation14116104410NANA2577Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93460Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed141349659NANA2578Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43242Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)1111711238NANA2579Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31267Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus1113011347NANA2580Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0018Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem112610NANA2581Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation40.252140NANA2582Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64718Neuroplasty and/or transposition; ulnar nerve at elbow400.257904NANA2583Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77065Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral300.332415612NANA2584Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex surgery; male to female200.510802NANA2585Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach200.510802NANA2586Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67971Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage200.517102NANA2587Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43999Unlisted procedure, stomach1019101NANA2588Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67917Repair of ectropion; extensive (eg, tarsal strip operations)10122301NANA2589Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27329Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm1012710NANA2590Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem310.941560526NANA2591Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes200.91865119NANA2592Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education490.86166401039NANA2593Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1080.8524662088NANA2594Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes250.842991520NANA2595Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan250.842766718NANA2596Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem190.793382217NANA2597Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session290.721748128NANA2598Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management250.681748124NANA2599Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management160.631758115NANA2600Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870Electroconvulsive therapy (includes necessary monitoring)216202NANA2601Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99442Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion21002NANA2602Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0373TAdaptive behavior treatment with protocol modification, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.119501NANA2603Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90887Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient112301NANA2604Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular111601NANA2605Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter.11001NANA2606Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99443Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion11001NANA2607Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0012Alcohol and/or drug services; subacute detoxification (residential addiction program outpatient)112801NANA2608Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0013Esketamine, nasal spray, 1 mg112510NANA2609Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97158Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes230.873577815NANA2610Carrier F2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours12000.008254817103NANA2611Carrier F2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes8500.01232991966NANA2612Carrier F2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes8000.013321032060NANA2613Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5514DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA3115.43NANA2614Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA11140.31NANA2615Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN230.8323.939.6518NANA2616Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE50.86.469.214NANA2617Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC40.756.462.113NANA2618Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP AND SPL SHOE MX DNSITY INSRT202NANA2619Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTL3000FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA101NANA2620Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5514DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA3115.43NANA2621Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA11140.31NANA2622Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN230.8323.939.6518NANA2623Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE50.86.469.214NANA2624Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC40.756.462.113NANA2625Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP AND SPL SHOE MX DNSITY INSRT202NANA2626Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3000FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA101NANA2627Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN2300.17423.939.6518NANA2628Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE500.26.469.214NANA2629Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC400.256.462.113NANA2630Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1970AFO PLASTIC WITH ANKLE JOINT CUSTOM FABRICATED90.8953.29NANA2631Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN230.8323.939.6518NANA2632Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS90.78359NANA2633Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM90.44104.29NANA2634Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0667SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG80.3885.78NANA2635Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA6550WND CARE SET NEG PRSS WND TX ELEC PUMP SPL110.3669.852.138NANA2636Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE110.3669.852.138NANA2637Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7000CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH110.3669.852.138NANA2638Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS120.3378.512NANA2639Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3000FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA13028112NANA2640Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7048VACUUM DRAINAGE COLLECTION UNIT AND TUBING KIT EA2117.42NANA2641Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL1150.11NANA2642Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL1150.11NANA2643Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5514DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA3115.43NANA2644Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA0425GROUND MILEAGE PER STATUTE MILE1191.31NANA2645Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA0428AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT1191.31NANA2646Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9270NONCOVERED ITEM OR SERVICE111201NANA2647Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA11140.31NANA2648Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0143WALKER FOLDING WHEELED ADJUSTABLE/FIXED HEIGHT1128.11NANA2649Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0261HOS BED SEMI-ELEC ANY TYPE SIDE RAIL W/O MATTRSS112131NANA2650Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS1200.2578.512NANA2651Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0466HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF400.572.34NANA2652Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC400.256.462.113NANA2653Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0241BATHTUB WALL RAIL EACH200.54.42NANA2654Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0245TUB STOOL OR BENCH200.54.42NANA2655Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA0425GROUND MILEAGE PER STATUTE MILE10191.31NANA2656Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA0428AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT10191.31NANA2657Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0143WALKER FOLDING WHEELED ADJUSTABLE/FIXED HEIGHT10128.11NANA2658Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1815DYN ADJ ANKLE EXT/FLEX DEVC INCL SOFT INTF MATL101126.81NANA2659Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0935CONTINUOUS PASSIVE MOT EXERCISE DEVC KNEE ONLY200.5168.611NANA2660Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38724CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ1219.857.157NANA2661Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS1016.7123.246NANA2662Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General250.9678.10223NANA2663Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE180.9415.682.8810NANA2664Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST110.912711NANA2665Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61510CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR110.911364.465NANA2666Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61781STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL160.885.369.679NANA2667Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD160.8166.264.1313NANA2668Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION140.7926.368.3311NANA2669Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED150.7326.366.5312NANA2670Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue200Intensive Care - General7107NANA2671Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue110Room & Board - Private - General31113NANA2672Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue113Room & Board - Private - Pediatric1146.21NANA2673Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue122Room & Board - Semiprivate - 2 Beds - OB1149.51NANA2674Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue127Room & Board - Semiprivate - 2 Beds - Oncology111NANA2675Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11646EXCISION MALIGNANT LESION F/E/E/N/L GT 4.0 CM1114.71NANA2676Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11042DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM OR LT2197.12NANA2677Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11045DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM2197.12NANA2678Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue206Intensive Care - Intermediate (ICU)51016741NANA2679Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue214Coronary Care - Intermediate Coronary Care Unit (CCU)4117.9031NANA2680Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue121Room & Board - Semiprivate - 2 Beds - Medical/Surgical/GYN500.8189.615NANA2681Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue113Room & Board - Private - Pediatric10146.21NANA2682Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue122Room & Board - Semiprivate - 2 Beds - OB10149.51NANA2683Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ7512PREDNISONE IMMEDIATE RLSE/DELAYED RLSE ORAL 1 MG1014.81NANA2684Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ9181INJECTION ETOPOSIDE 10 MG1014.81NANA2685Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ9312INJECTION RITUXIMAB 10 MG1014.81NANA2686Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15740FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY400.5127.84NANA2687Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58571LAPS TOTAL HYSTERECT 250 GM OR LT W/RMVL TUBE/OVARY1011201NANA2688Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61580CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ101195.31NANA2689Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61600RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL101195.31NANA2690Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99231SBSQ HOSPITAL CARE/DAY 15 MINUTES11241NANA2691Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General1157.51NANA2692Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES11241NANA2693Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN OR LT11241NANA2694Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57335VAGINOPLASTY INTERSEX STATE21169.32NANA2695Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS21169.32NANA2696Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT44955APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX1195.71NANA2697Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric3124021NANA2698Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15570FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK101NANA2699Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15877SUCTION ASSISTED LIPECTOMY TRUNK101NANA2700Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General1157.51NANA2701Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES11241NANA2702Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99231SBSQ HOSPITAL CARE/DAY 15 MINUTES11241NANA2703Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN OR LT11241NANA2704Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS21338.62NANA2705Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57335VAGINOPLASTY INTERSEX STATE21338.62NANA2706Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44955APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX1195.71NANA2707Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric3148021NANA2708Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15570FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK101NANA2709Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15877SUCTION ASSISTED LIPECTOMY TRUNK101NANA2710Carrier G2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120Room & Board - Semiprivate - 2 Beds - General10157.51NANA2711Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61782STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL20.518.42NANA2712Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31299UNLISTED PROCEDURE ACCESSORY SINUSES20.518.42NANA2713Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC20.514.911NANA2714Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49320LAPS ABD PRTM and OMENTUM DX W/WO SPEC BR/WA SPX20.514.911NANA2715Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63266LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC1043.61NANA2716Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31622BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX202NANA2717Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47120HEPATECTOMY RESCJ PARTIAL LOBECTOMY101NANA2718Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT39561RESCJ DIAPHRAGM W/COMPLEX REPAIR101NANA2719Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE2043.620.611NANA2720Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33518CORONARY ARTERY BYP W/VEIN and ARTERY GRAFT 2 VEIN2011NANA2721Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44186LAPAROSCOPY SURGICAL JEJUNOSTOMY1114.91NANA2722Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99222INITIAL HOSPITAL CARE/DAY 50 MINUTES1101NANA2723Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99223INITIAL HOSPITAL CARE/DAY 70 MINUTES1101NANA2724Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31040PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH1137.81NANA2725Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31241NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY1137.81NANA2726Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31255NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY1137.81NANA2727Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31256NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY1137.81NANA2728Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31257NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY1137.81NANA2729Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31259NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL1137.81NANA2730Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31276NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS1137.81NANA2731Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0011ALCOHOL and / DRUG SERVICES; ACUTE DTOX RES PROG IP15110.415NANA2732Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN120.92105.512NANA2733Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN120.92105.512NANA2734Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0018BHVAL HEALTH; SHORT-TERM RES W/O ROOM and BOARD-DIEM130.9217.722112NANA2735Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-1100.8637.195.84106NANA2736Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV and MN150.677715NANA2737Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M170.6571.9116NANA2738Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY W/PATIENT W/E and M SRVCS 30 MIN110.6453.411NANA2739Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG190.6371.9118NANA2740Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION170.4747.369.1314NANA2741Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room & Board - Semiprivate - 2 Beds - Detoxification4124.34NANA2742Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912Behavioral Health Treatments_Services - Partial hospitalizat2135.52NANA2743Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue905Behavioral Health Treatments/Services -IOP Psychiatric11961NANA2744Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81381HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP212NANA2745Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906Behavioral Health Treatments/Services - IOP Chemical Depende1155.21NANA2746Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL1171.41NANA2747Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81380HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA111NANA2748Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906Behavioral Health Treatments_Services - Intensive outpatient11481NANA2749Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90846FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS1101NANA2750Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92521EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)116.91NANA2751Carrier G2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue126Room & Board - Semiprivate - 2 Beds - Detoxification400.2524.34NANA2752Carrier G2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT71271COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-11000.00937.195.84106NANA2753Carrier G2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION1700.05947.369.1314NANA2754Carrier G2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG0283E-STIM 1 OR GT AREAS OTH THAN WND CARE PART TX PLAN10174.61NANA2755Carrier H2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips1460.725.921.9129117NANA2756Carrier H2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips1460.725.921.9129117NANA2757Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab3290.993.710.150329NANA2758Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width180.95100.364.18018NANA2759Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair250.9275.843.16025NANA2760Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)470.8869.232.88047NANA2761Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr200.8556.352.35020NANA2762Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified830.8783.25083NANA2763Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1846Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens210.6268.312.85021NANA2764Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications360.4881.233.38036NANA2765Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (non-invasive)380.4379.353.31038NANA2766Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive330.0485.033.54033NANA2767Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each1512498.82114NANA2768Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination12160012NANA2769Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-in-space, Rigid, Adj, Wo Seating5167.205NANA2770Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2617Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type516805NANA2771Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2609Custom Fabricated Wheelchair Seat Cushion, Any Size5182.2905NANA2772Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)518405NANA2773Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1002Wheelchair Accessory, Power Seating System, Tilt Only41110.404NANA2774Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2310Power Wheelchair Accessory, Electronic Connection Between Wheelchair Controller A& One Power Seating System Motor, Incl All Related Electronics, Indicator Feature, Mechanical315603NANA2775Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1234Wheelchair, Pediatric Size, Tilt-in-space, Folding, Adj, Wo Seating318803NANA2776Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement218402NANA2777Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0005Ultralightweight Wheelchair250175.84025NANA2778Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr200156.35020NANA2779Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2620Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width1801100.36018NANA2780Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8619Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement9018009NANA2781Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0766Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Type800.59.657.626NANA2782Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0986Manual Wheelchair Accessory, Push-rim Activated Power Assist, Each5017605NANA2783Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5856Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System,50124100.814NANA2784Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0766Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Type1017201NANA2785Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0747Osteogenesis Stimulator (non-invasive)10112001NANA2786Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL1846Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens1019601NANA2787Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple290.97070.59128NANA2788Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy550.9180.28055NANA2789Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)440.9198.77044NANA2790Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22551Arthrodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C2350.8933.687.27233NANA2791Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy W Facetectomy-lumbar290.87079.76128NANA2792Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrod,interbdy Tech;lumbar,allogf530.822478.48251NANA2793Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Replacement Knee Total250.822483124NANA2794Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, Combined Posterior Or Posterolateral Technique Wi/ Posterior Interbody Technique Incl Laminectomy And/or Discectomy Sufficient To Prepare Interspace, Lumbar430.774073.67241NANA2795Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22630Arthrodesis Post Interbody-lumbar100.793.82010NANA2796Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Lumbar (with Lateral Transverse Technique, When Performed)110.642486.77110NANA2797Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75894Transcatheter Therapy Embolize Any Meth812451.4317NANA2798Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361Transcatheter Aortic Valve Replacement (tavr/tavi) With Prosthetic Valve; Percutaneous Femoral Artery Approach712475.4316NANA2799Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63048Laminectomy, Facetectomy & Foraminotomy (unilateral Or Bilateral W/ Decompression Of Spinal Cord, Cauda Equina And/or Nerve Root[s], Single Vertebral Segment; Each Addtl61133.7106NANA2800Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy W Facetectomy-cervical61247215NANA2801Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134Revis.tot.hip Arthropl;both Compnts517205NANA2802Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22802Arthrod,post,spin.deform,gft;7+vert415404NANA2803Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22600Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Cervical Below C2 Segment41245613NANA2804Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specimen(s) By Brushing Or Washing, When Performed (separate Procedure)317803NANA2805Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decompression Of Spinal Cord &/or Nerve Roots; Cervical Below C2 Each Additional Interspac31248412NANA2806Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-lateral,ea Add.in3104812NANA2807Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558Arthrod,interbdy Tech;lumbar,allogf53012478251NANA2808Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)4401098.77044NANA2809Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22551Arthrodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C235013487233NANA2810Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple2901070.59128NANA2811Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047Laminectomy W Facetectomy-lumbar2901080128NANA2812Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total25012483124NANA2813Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22630Arthrodesis Post Interbody-lumbar1001093.82010NANA2814Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22533Arthrodesis, Lateral Extracavitary Technique, Including Minimal Diskectomy To Prepare Interspace; Lumbar901248718NANA2815Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex Op Male To Female70107607NANA2816Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22614Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Interspace (list Separately In Addition To Code For Primary Procedure)5012419214NANA2817Carrier H2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation130.462717.0967NANA2818Carrier H2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric202523.1211NANA2819Carrier H2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation130.462717.0967NANA2820Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home Sleep Test W/type Iii Portable Monitor38450.97303845NANA2821Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echocardiography, Transthoracic, Real-time W/ Image Documentation (2d), Includes M-mode Recording, When Performed70100.9503.3427008NANA2822Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A35490.950643545NANA2823Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Ct Abd & Pelvis W/o Contrast66730.940.185.09226651NANA2824Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specimen(s) By Brushing Or Washing, When Performed (separate Procedure)29270.90.69491542773NANA2825Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic Resonance Imaging, Any Jnt-lowe60520.890746048NANA2826Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy Flexible, Transoral; With Biopsy, Single Or Multiple32840.890.59491863098NANA2827Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri,spin.canal,cerv;w/o Contrst Mat23940.86010.332391NANA2828Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri,spin.canal,lumb;w/o Cntrst Matl42760.851964270NANA2829Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity30780.850823076NANA2830Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically Aided Anter,cruciate Li14211872.814138NANA2831Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95806Sleep Study, Unattended, Simultaneous Recording Of, Heart Rate, Oxygen Saturation, Respiratory Airflow, And Respiratory Effort (eg Thoracoabdominal Movement)801104.59080NANA2832Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77371Radiation Treatment Delivery, Sterotactic Radiosurgery (srs), Complete Course Of Treatment Of Cranial Lesion(s) Consisting Of 1 Session; Multi-source Cobalt 60 Based63120063NANA2833Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29874Arthroscop Knee W Remov Loose Body581873355NANA2834Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29875Arthroscopy,knee,surg;synovec,limited-se5011074545NANA2835Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78472Card Bld Pool Image; 1 Rest W/motn3410034NANA2836Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95800Slp Stdy Unatnd W/hrt Rate/o2 Sat/resp/slp Time3210032NANA2837Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77386Intensity Modulated Radiation Treatment Delivery (imrt), Includes Guidance And Tracking, When Performed; Complex41153911031NANA2838Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29876Arthroscopy, Knee, Surgical; With Lateral Release2718868028NANA2839Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29879Arthroscopy, Knee, Surgical; Abrasion Arthroplasty (includes Chondroplasty Where Necessary) Or Multiple Drilling Or Microfracture2812495127NANA2840Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29881Arthroscopy, Knee, With Meniscectomy Including Debridement/shaving Of Articular Cartilage, Same Or Separate Compartment(s), When Performed50101177423478NANA2841Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77402Radiation Treatment Delivery, >= 1 Mev; Simple3290140329NANA2842Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29880Arthroscopy, Knee, With Meniscectomy Including Debridement/shaving Of Articular Cartilage, Same Or Separate Compartment(s), When Performed137010731136NANA2843Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29877Arthroscopy,knee,surg;debride/shave A.ca1190121778111NANA2844Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31255Nasal/sinus Endoscopy,surgical; With Ethmoidectomy,total (anterior And Posterior)99011663396NANA2845Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT75572Ct Heart Contrast Eval Cardiac Structure&morph53010053NANA2846Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29883Arthroscop Knee W Tot Meniscus Rep530170053NANA2847Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72147Mri,spinal Canal/contents,thorac;w/cntrs51010051NANA2848Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63042Laminotomy W Dec Nrv Rts;reex;lumb49011977544NANA2849Carrier H2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27446Arthropls,knee,cond/plat;medor Lat340183034NANA2850Carrier H2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MGMT1960.8224641153NANA2851Carrier H2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT1500.7924651149NANA2852Carrier H2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, SUBSEQUENT DELIVERY AND MGMT.2510.6924681171NANA2853Carrier H2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MGMT1960.8224641153NANA2854Carrier H2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT1500.7924651149NANA2855Carrier H2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, SUBSEQUENT DELIVERY AND MGMT.2510.6924681171NANA2856Carrier H2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, SUBSEQUENT DELIVERY AND MGMT.25100.0524681171NANA2857Carrier H2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MGMT19600.0924641153NANA2858Carrier H2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT15000.1324651149NANA2859Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin110.9170.3548788611NANA2860Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc100.0021925011NANA2861Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl100.0020758321NANA2862Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.002136111NANA2863Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin110.9170.3548788611NANA2864Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc100.0021925011NANA2865Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl100.0020758321NANA2866Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.002136111NANA2867Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0784Ext Amb Infusn Pump Insulin1100.0970.3548788611NANA2868Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1151.84393251NANA2869Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]2390.982.043918472239NANA2870Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)130.854.68177350413NANA2871Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)30.679.3617592593NANA2872Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor40.2596.940069444NANA2873Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2624Adj skin pro/pos cus<22in100.0863583311NANA2874Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi100.0864722211NANA2875Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height100.0863130551NANA2876Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in100.0864102771NANA2877Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension100.0862741661NANA2878Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2300Power wheelchair accessory, power seat elevation system2012.068752NANA2879Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1026.893509171NANA2880Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab100.0708333341NANA2881Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1151.84393251NANA2882Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]2390.982.043918472239NANA2883Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)130.854.68177350413NANA2884Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)30.679.3617592593NANA2885Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor40.2596.940069444NANA2886Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2624Adj skin pro/pos cus<22in100.0863583311NANA2887Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi100.0864722211NANA2888Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height100.0863130551NANA2889Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in100.0864102771NANA2890Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension100.0862741661NANA2891Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2300Power wheelchair accessory, power seat elevation system2012.068752NANA2892Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1026.893509171NANA2893Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab100.0708333341NANA2894Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63012Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)213.6705434262NANA2895Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)30.677.3848260283NANA2896Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)30.677.3848260283NANA2897Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar20.536.497463472NANA2898Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)301.0912043523NANA2899Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT52005Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;300.0583891663NANA2900Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT62141Cranioplasty for skull defect; larger than 5 cm diameter200.0819916672NANA2901Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT52332Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)200.0461218062NANA2902Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);200.0029166672NANA2903Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61512Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial201.5933333342NANA2904Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)202.859898612NANA2905Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61781Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)300.0869444451.59333333412NANA2906Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15750Flap; neurovascular pedicle200.0872222210.00582777811NANA2907Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)1124.151111111NANA2908Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63012Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)213.6705434262NANA2909Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22630Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar110.1066666671NANA2910Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft1119.344111111NANA2911Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27446Arthroplasty, knee, condyle and plateau; medial OR lateral compartment1111.445151941NANA2912Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component1121.714321391NANA2913Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach111.8211111131NANA2914Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33362Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach111.8211111131NANA2915Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47135Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age1117.831NANA2916Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible11240.52684721NANA2917Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk11240.52685081NANA2918Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43644Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)112.7388888871NANA2919Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder14143.0727314814NANA2920Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric2121.580138892NANA2921Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric1188.886666671NANA2922Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification110.20196751NANA2923Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder14143.0727314814NANA2924Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric2121.580138892NANA2925Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric1188.886666671NANA2926Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification110.20196751NANA2927Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1320.9414.74452149132NANA2928Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2110.939.101342806211NANA2929Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation1560.936.463750842156NANA2930Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis2230.8916.77075072223NANA2931Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1400.850.2805555587.62105902867211391NANA2932Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr1480.8513.98278651148NANA2933Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility2700.7430.39479178270NANA2934Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes2560.7233.19778745256NANA2935Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes1960.6828.1757568196NANA2936Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities1390.6238.76119208139NANA2937Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng3112.59238215531NANA2938Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-2710.00016460927NANA2939Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)24128.4717952324NANA2940Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70491Contrast CAT scan of neck tissue1917.38042397719NANA2941Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions1710.12427091517NANA2942Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr14124.0380740714NANA2943Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1112.04002314811NANA2944Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl910.0001851859NANA2945Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93308ECHO, transthoracic, heart, limited813.3559027788NANA2946Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64635Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint7125.148726837NANA2947Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0398Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation7115.692222227NANA2948Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95805Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness710.0001190487NANA2949Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70480CT, orbit, sella or pos fos wo contrast710.0818253977NANA2950Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction7113.323677567NANA2951Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70460Contrast CAT scan of head/brain20.573.522777782NANA2952Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT62321Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)60.1712.312168256NANA2953Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64405Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve130.1538.69889613NANA2954Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27096Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed160.0623.8912591816NANA2955Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine1400.010.2805555587.62105902867211391NANA2956Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70553MRI of brain and further sequences1320.0114.74452149132NANA2957Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services7119.332063497NANA2958Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management8162.7141666639.6011111117NANA2959Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session7162.7141666646.2003703716NANA2960Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5135.119157785NANA2961Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management6162.7141666645.7702777815NANA2962Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours110.9151.7862626311NANA2963Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-60.8310.377777786NANA2964Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual170.8234.6830542917NANA2965Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92526Treatment of swallowing dysfunction and/or oral function for feeding90.5659.487226729NANA2966Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete40.580.902685194NANA2967Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction40.580.902685194NANA2968Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77386Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex110.0039027791NANA2969Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services7119.332063497NANA2970Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management8162.7141666639.6011111117NANA2971Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session7162.7141666646.2003703716NANA2972Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5135.119157785NANA2973Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management6162.7141666645.7702777815NANA2974Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences310.000370373NANA2975Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue3163.600925933NANA2976Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach2121.311388892NANA2977Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes1145.008333341NANA2978Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant113.031388891NANA2979Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92523Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)110.0752777781NANA2980Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin910.9261.0668338291NANA2981Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl8018.080447338NANA2982Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM8017.181224568NANA2983Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc8018.080489138NANA2984Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys7020.04446257NANA2985Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit Of Service 2017-07-01 00:00:00.000 2199-12-31 23:59:59.000 ADD2010.041666672NANA2986Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continueous monitor system100.0941666671NANA2987Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274Ext amb insuline delivery sys100.0048241661NANA2988Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin910.9261.0668338291NANA2989Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl8018.080447338NANA2990Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM8017.181224568NANA2991Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc8018.080489138NANA2992Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys7020.04446257NANA2993Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit Of Service 2017-07-01 00:00:00.000 2199-12-31 23:59:59.000 ADD2010.041666672NANA2994Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continueous monitor system100.0941666671NANA2995Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274Ext amb insuline delivery sys100.0048241661NANA2996Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)1760.9746.347777781.6665984131175NANA2997Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]34830.9646.347777782.304491152612134822NANA2998Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)740.8633.6302777810.69826984470NANA2999Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal80.38136.73588958NANA3000Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER70.2933.63027778111.890370443NANA3001Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi200.2571.13215972122.0365107218NANA3002Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor250.2110.539243625NANA3003Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine190.16130.546169819NANA3004Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi7040.980903177NANA3005Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B6047.796694636NANA3006Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height6030.691410326NANA3007Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1146.3477777857611NANA3008Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0561Humidifier, non-heated, used with positive airway pressure device1146.347777781NANA3009Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified41140.61145834NANA3010Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)1760.9746.347777781.6665984131175NANA3011Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]34830.9646.347777782.304491152612134822NANA3012Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)740.8633.6302777810.69826984470NANA3013Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal80.38136.73588958NANA3014Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER70.2933.63027778111.890370443NANA3015Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi200.2571.13215972122.0365107218NANA3016Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor250.2110.539243625NANA3017Carrier J2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]34830046.347777782.304491152612134822NANA3018Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)440.9346.5221863244NANA3019Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)210.939.5050889421NANA3020Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar200.941.6077904320NANA3021Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar250.8857.31271103480251NANA3022Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)320.8847.1175347732NANA3023Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);330.211.42881083432.52842918429NANA3024Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)240.080.0027777778.561956111123NANA3025Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis280.070.00678333216.29482006226NANA3026Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump2000.0055555566.504863889119NANA3027Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve21016.8506751422.84802685615NANA3028Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar19148.3796979719NANA3029Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft12170.437058712NANA3030Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))11138.0734598911NANA3031Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion7155.48255267NANA3032Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22634Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)5152.860691825NANA3033Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22843Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)5119.049772325NANA3034Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63042Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar4172.864977194NANA3035Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22216Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)4115.812225864NANA3036Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)4150.717728134NANA3037Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22214Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar3124.990004223NANA3038Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)3117.875292923NANA3039Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43279Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed31121.18768523NANA3040Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22846Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)3154.816303833NANA3041Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23470Arthroplasty, glenohumeral joint; hemiarthroplasty318.0435268523NANA3042Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22802Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments3141.491192433NANA3043Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical315.1079698330.38467861121NANA3044Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNARoom and board, Semi Private Detoxification4146.050347224NANA3045Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state31128.31685193NANA3046Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach31128.31685193NANA3047Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete2126.241388892NANA3048Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra2126.16163582NANA3049Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57110Vaginectomy, complete removal of vaginal wall;1171.766388891NANA3050Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56800Plastic repair of introitus11332.46777781NANA3051Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57292Construction of artificial vagina; with graft11332.46777781NANA3052Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57291Construction of artificial vagina; without graft1126.959166671NANA3053Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra1171.766388891NANA3054Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNAAlcohol and/or other drug treatment program, per diem1118.84751NANA3055Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55180Scrotoplasty; complicated1171.766388891NANA3056Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNARoom and board, Semi-Private, Psychiatric320.948.061203704269.5459427329NANA3057Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAResidential treatment, Substance Use Disorder2380.9350.64727495238NANA3058Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAResidential treatment, Psychiatric470.7228.53694444241.0093836344NANA3059Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT13121Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm20.570.939782112NANA3060Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNACrisis Intervention Mental H100.0053619431NANA3061Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15002Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children1048.621399171NANA3062Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64859Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure)1048.621399171NANA3063Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15240Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less1048.621399171NANA3064Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNAAlcohol And/Or Drug Services100.0032269441NANA3065Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15273Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children1048.621399171NANA3066Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15274Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)1048.621399171NANA3067Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15277Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children1048.621399171NANA3068Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64910Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve1048.621399171NANA3069Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15574Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet1048.621399171NANA3070Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15750Flap; neurovascular pedicle1048.621399171NANA3071Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15100Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)1048.621399171NANA3072Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15757Free skin flap with microvascular anastomosis1048.621399171NANA3073Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT14301Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm1048.621399171NANA3074Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT29125Application of short arm splint (forearm to hand); static1048.621399171NANA3075Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT31587Laryngoplasty, cricoid split, without graft placement10246.251NANA3076Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64856Suture of major peripheral nerve, arm or leg, except sciatic; including transposition1048.621399171NANA3077Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT51102Aspiration of bladder; with insertion of suprapubic catheter1048.621399171NANA3078Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64874Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture)1048.621399171NANA3079Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97606Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters1048.621399171NANA3080Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT13122Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)1048.621399171NANA3081Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT14040Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less1048.621399171NANA3082Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT14302Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)1048.621399171NANA3083Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT14041Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm1048.621399171NANA3084Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15003Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)1048.621399171NANA3085Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15101Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)1048.621399171NANA3086Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970Intersex surgery; male to female10261.61NANA3087Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification4146.050347224NANA3088Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state31128.31685193NANA3089Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach31128.31685193NANA3090Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete2126.241388892NANA3091Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra2126.16163582NANA3092Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57110Vaginectomy, complete removal of vaginal wall;1171.766388891NANA3093Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56800Plastic repair of introitus11332.46777781NANA3094Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57292Construction of artificial vagina; with graft11332.46777781NANA3095Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57291Construction of artificial vagina; without graft1126.959166671NANA3096Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra1171.766388891NANA3097Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem1118.84751NANA3098Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55180Scrotoplasty; complicated1171.766388891NANA3099Carrier J2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue1001Residential treatment, Psychiatric4700.0228.53694444241.0093836344NANA3100Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation17170.964.551587741717NANA3101Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences15350.950.08759.11342266431532NANA3102Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete27820.940.0872222216.2601454696601278110NANA3103Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis30240.943.5201149439.638329536292995NANA3104Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr25110.880.23972222211.00589676648125105NANA3105Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine18450.861.0481944448.480348817672218432NANA3106Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility55250.749.45408001339.65143342610.519550616NANA3107Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes50400.7317.552093642.139664875911950218NANA3108Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes46570.7324.9135211639.53006852810.66666671246459NANA3109Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities36790.7148.7211516743.901583385681136683NANA3110Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63685Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling23131.10083644600231NANA3111Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77435Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions18111.7404629659.415407416003151NANA3112Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))31131.758682537.73359205130NANA3113Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72147Contrast MRI of thoracic spine2912.43074712729NANA3114Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63042Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar30151.4807861132.48858983228NANA3115Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64492Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)2513.86894268325NANA3116Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78472Nuclear scan, cardiac blood pool2210.00011363622NANA3117Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)22160.9581296522NANA3118Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77373Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions17111.7404629660.40331349314NANA3119Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77432Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)1311.97444444486.46290404211NANA3120Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64405Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve9300.040.22140416754.877798546482911NANA3121Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64493Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level30900.0323.4483643115.212168182307NANA3122Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64479Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level15300.0214.66959782153NANA3123Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical4000.0342.6052056540NANA3124Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64520Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)2100.0515.3693431821NANA3125Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78459MYOCRD IMG PET METAB EVAL SINGLE STUDY800.1328.070486118NANA3126Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63020Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical700.1446.311051767NANA3127Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63655Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural500.275.656156875NANA3128Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23470Arthroplasty, glenohumeral joint; hemiarthroplasty500.280.849107555NANA3129Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT62290Injection procedure for discography, each level; lumbar400.2544.091728754NANA3130Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services18717.52954805532.137499779178NANA3131Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem990.9743.7772355899NANA3132Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete350.9483.99884921696351NANA3133Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction340.94243.657777885.11815657133NANA3134Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours1150.9154.6793055662.029265652113NANA3135Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session780.925.8108971247.675709085529691NANA3136Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-1980.93.088960078198NANA3137Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management520.922.3572951244.10535269745NANA3138Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management820.8925.8108966344.54946906973NANA3139Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual2820.73314.702052867.410744061281NANA3140Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services18717.52954805532.137499779178NANA3141Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1210.02682870412NANA3142Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes71268.13452387NANA3143Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue51103.43916675NANA3144Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81243FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles4126.465138894NANA3145Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81229Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities4125.550069444NANA3146Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions417.3549659724NANA3147Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant3188.21370373NANA3148Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95810Polysomnography; Age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist410.289444445013NANA3149Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77373Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions2132.127638892NANA3150Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56625Vulvectomy simple; complete2181.962222222NANA3151Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78608Brain imaging, PET, metabolic eval2113.578888892NANA3152Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81415Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis2117.923472222NANA3153Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81416Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)2117.923472222NANA3154Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach21119.018752NANA3155Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple21119.018752NANA3156Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ3014Telehealth originating site facility fee2150.492760142NANA3157Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin617.03060NANA3158Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories1123.5010NANA3159Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1123.5010NANA3160Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit of Service�20.585.5020NANA3161Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system20.585.5020NANA3162Carrier K2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin617.03060NANA3163Carrier K2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories1123.5010NANA3164Carrier K2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1123.5010NANA3165Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications�3140.5030NANA3166Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes2184.9020NANA3167Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5301Below knee, molded socket, shin, sach foot, endoskeletal system21104.7020NANA3168Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5620Addition to lower extremity, test socket, below knee21104.7020NANA3169Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5629Addition to lower extremity, below knee, acrylic socket21104.7020NANA3170Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5637Addition to lower extremity, below knee, total contact21104.7020NANA3171Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5645Addition to lower extremity, below knee, flexible inner socket, external frame�21104.7020NANA3172Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5671Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert21104.7020NANA3173Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5673Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism21104.7020NANA3174Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous30140.8030NANA3175Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications�3140.5030NANA3176Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5301Below knee, molded socket, shin, sach foot, endoskeletal system21104.7020NANA3177Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620Addition to lower extremity, test socket, below knee21104.7020NANA3178Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5629Addition to lower extremity, below knee, acrylic socket21104.7020NANA3179Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637Addition to lower extremity, below knee, total contact21104.7020NANA3180Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5645Addition to lower extremity, below knee, flexible inner socket, external frame�21104.7020NANA3181Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5671Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert21104.7020NANA3182Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5673Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism21104.7020NANA3183Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910Addition, endoskeletal system, below knee, alignable system21104.7020NANA3184Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5940Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)21104.7020NANA3185Carrier K2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399Durable medical equipment, miscellaneous101325.44010NANA3186Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)3137.3030NANA3187Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11970Replacement of tissue expander with permanent implant2122020NANA3188Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11971Removal of tissue expander without insertion of implant2156020NANA3189Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19380Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)2122020NANA3190Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49999Unlisted procedure, abdomen, peritoneum and omentum�21115020NANA3191Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT14302Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)20.5108.8020NANA3192Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15240Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less20.5108.8020NANA3193Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15241Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)20.5108.8020NANA3194Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT52332Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)20.5118.3020NANA3195Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra20.5108.5020NANA3196Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)3137.3030NANA3197Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11970Replacement of tissue expander with permanent implant2122020NANA3198Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11971Removal of tissue expander without insertion of implant2156020NANA3199Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19380Unlisted procedure, abdomen, peritoneum and omentum�2122020NANA3200Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49999Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)21115020NANA3201Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5519.73.664510NANA3202Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)53112.93.83500NANA3203Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure�530.9610.280530NANA3204Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81420Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21350.949.80350NANA3205Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)�1260.910.215.111250NANA3206Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique�850.910.215.111840NANA3207Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45384Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps650.910.216.41640NANA3208Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1110.925.117.0121090NANA3209Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist290.5948.936.82270NANA3210Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist360.542.352.91340NANA3211Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5519.73.664510NANA3212Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)53112.93.83500NANA3213Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)�2011.30200NANA3214Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43248Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire1110.20110NANA3215Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81374HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each�1010.170100NANA3216Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81162BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements)�1010.120100NANA3217Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64490Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level�915.7090NANA3218Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52356Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)13111.32.1580NANA3219Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81241F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant714.2070NANA3220Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93656Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation, including intracardiac electrophysiologic 3-dimensional mapping, intracardiac echocardiography including imaging supervision and interpretation, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, right ventricular pacing/recording, and His bundle recording, when performed�712545.6160NANA3221Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory41117.2040NANA3222Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable20.5106.8020NANA3223Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)�20.546.4020NANA3224Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous40100040NANA3225Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9999Miscellaneous dme supply or accessory, not otherwise specified30139.4030NANA3226Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment20124.7020NANA3227Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930SP BONE ALGRFT MORSEL ADD-ON61290600NANA3228Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936SP BONE AGRFT LOCAL ADD-ON61290600NANA3229Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22556ARTHRD ANT NTRBD MIN DSC THC61290600NANA3230Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22610ARTHRD PST TQ 1NTRSPC THRC61290600NANA3231Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840INSERT SPINE FIXATION DEVICE61290600NANA3232Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMECHANICAL DEVICE61290600NANA3233Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63064DECOMPRESS SPINAL CORD THRC61290600NANA3234Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)40.7519.347.313NANA3235Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk2141.42NANA3236Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible2141.42NANA3237Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20930SP BONE ALGRFT MORSEL ADD-ON61290600NANA3238Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20936SP BONE AGRFT LOCAL ADD-ON61290600NANA3239Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22556ARTHRD ANT NTRBD MIN DSC THC61290600NANA3240Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610ARTHRD PST TQ 1NTRSPC THRC61290600NANA3241Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840INSERT SPINE FIXATION DEVICE61290600NANA3242Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853INSJ BIOMECHANICAL DEVICE61290600NANA3243Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63064DECOMPRESS SPINAL CORD THRC61290600NANA3244Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk2141.42NANA3245Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible2141.42NANA3246Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49568Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection2141.42NANA3247Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)1920.840.216.161860NANA3248Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1850.836.717.971780NANA3249Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique1380.80411.619.641340NANA3250Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45384Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps860.8119.20860NANA3251Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure740.939.70740NANA3252Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple660.980.44.27590NANA3253Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)640.980.24.46580NANA3254Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist620.6122.843.21610NANA3255Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist490.634847.41480NANA3256Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81420Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21270.967.70270NANA3257Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)110346.08010NANA3258Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple110684.48010NANA3259Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure110344.88010NANA3260Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29827SHO ARTHRS SRG RT8TR CUF RPR0NANA3261Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29822SHO ARTHRS SRG LMTD DBRDMT0NANA3262Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT25390SHORTEN RADIUS OR ULNA0NANA3263Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27279ARTHRODESIS SACROILIAC JOINT0NANA3264Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY0NANA3265Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29828SHO ARTHRS SRG BICP TENODSIS0NANA3266Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29846WRIST ARTHROSCOPY/SURGERY0NANA3267Carrier L2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin9113.716.4180NANA3268Carrier L2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit of Service110.1010NANA3269Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory41117.2040NANA3270Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous40100040NANA3271Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9999Miscellaneous dme supply or accessory, not otherwise specified30139.4030NANA3272Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment20124.7020NANA3273Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable20.5106.8020NANA3274Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)�20.546.4020NANA3275Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)120.5167012NANA3276Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST12121.2012NANA3277Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM110.545570.353.1110NANA3278Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)100.857.4010NANA3279Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);10192.411.219NANA3280Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG100.863.488.519NANA3281Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720ELECTROENCEPHALOGRAM (EEG), CONTINUOUS RECORDING, PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL REVIEW OF RECORDED EVENTS, ANALYSIS OF SPIKE AND SEIZURE DETECTION, EACH INCREMENT OF GREATER THAN 12 HOURS, UP TO 26 HOURS OF EEG RECORDING, INTERPRE100.644.2010NANA3282Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY8117.108NANA3283Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT80.62545.508NANA3284Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION70.714314907NANA3285Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST12121.2012NANA3286Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);10192.411.219NANA3287Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY8117.108NANA3288Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY, SURGICAL;COLECTOMY, PARTIAL, WITH ANASTOMOSIS716.207NANA3289Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9208INJECTION, IFOSFAMIDE, 1 GRAM71102.307NANA3290Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)71100.707NANA3291Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP6150.806NANA3292Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45330SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)6120.706NANA3293Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT516.53.314NANA3294Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9181INJECTION, ETOPOSIDE, 10 MG51124.105NANA3295Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM1100.5570.353.1110NANA3296Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE; LUMBAR600.3363.463.815NANA3297Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)1000.857.4010NANA3298Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG1000.863.488.519NANA3299Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20930ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)1200.5167012NANA3300Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63053LAMINECTOMY, FACETECTOMY, OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG, SPINAL OR LATERAL RECESS STENOSIS)), DURING POSTERIOR INTERBODY ARTHRODESIS, LUMBAR; EACH ADDITIONAL SEGMENT (LIS10025.301NANA3301Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO400.591.904NANA3302Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27279ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE (INDIRECT VISUALIZATION), WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, AND PLACEMENT OF TRANSFIXING DEVICE1002401NANA3303Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT800.6345.508NANA3304Carrier M2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20931ALLOGRAFT, STRUCTURAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)200.5273.702NANA3305Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585Botox1410.8926422139NANA3306Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION981427.4197NANA3307Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSTD EMBRYO HATCHING MICROTQS ANY METH940.57107.8094NANA3308Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89258CRYOPRSRV EMBRYO890.7594.4089NANA3309Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)810.7881.3081NANA3310Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318BREAST REDUCTION810.769.5081NANA3311Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS4022ASST OOCYTE FERT CASE RATE730.4291.5073NANA3312Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS4016FROZEN IVF CASE RATE660.8955.8066NANA3313Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT620.982414.3062NANA3314Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS4011IVF PACKAGE610.6798061NANA3315Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION981427.4197NANA3316Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED52155.4052NANA3317Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D & C33119.178.8132NANA3318Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36478ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS,LASER, FIRST VEIN TREATED16151.8016NANA3319Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66982EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIRING DEVICES OR TECHNIQUES NOT GENERALLY USED IN ROUTIN15110.8015NANA3320Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19380REVJ RECONSTRUCTED BREAST13124.1013NANA3321Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19357TISSUE EXPANDER PLACEMENT IN BREAST RECONSTRUCTION, INCLUDING SUBSEQUENT EXPANSION(S)1317.8013NANA3322Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15823BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID12124.9012NANA3323Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36471NJX SCLEROSING SOLUTION MULTIPLE VEINS SAME LEG11154.4011NANA3324Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99354PROLNG SVC O/P 1ST HOUR10133.961.628NANA3325Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS6100.6738.1061NANA3326Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89258CRYOPRSRV EMBRYO8900.7594.4089NANA3327Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT5400.7639.3054NANA3328Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS4011IVF PACKAGE6100.6798061NANA3329Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89342STORAGE, (PER YEAR); EMBRYO(S)8100.7881.3081NANA3330Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31267NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS3000.531.960.6129NANA3331Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19318BREAST REDUCTION8100.769.5081NANA3332Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31276NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION2700.599.779.2225NANA3333Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS4015COMPLETE IVF NOS CASE RATE2600.73205.6026NANA3334Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89253ASSTD EMBRYO HATCHING MICROTQS ANY METH9400.57107.8094NANA3335Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY470.9126.8249.3443NANA3336Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY7111.424.443NANA3337Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH INPATIENT219602NANA3338Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNADETOXIFICATION110.101NANA3339Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY7111.424.443NANA3340Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH INPATIENT219602NANA3341Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNADETOXIFICATION110.101NANA3342Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY470.9126.8249.3443NANA3343Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNAMENTAL HEALTH INPATIENT2019602NANA3344Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY70111.424.443NANA3345Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNADETOXIFICATION1010.101NANA3346Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY4700.9126.8249.3443NANA3347Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MH PARTIAL HOSP TX UNDER 24H930.989.8328.8291NANA3348Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A750.99491.7075NANA3349Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN660.88803.1066NANA3350Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES650.92740.1065NANA3351Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES600.98636.2060NANA3352Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM460.8781.2109.1244NANA3353Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT420.93730.4042NANA3354Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION380.61239.9038NANA3355Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT350.57204035NANA3356Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT180.56285.2018NANA3357Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY, 30 MINUTES WITH PATIENT5110.905NANA3358Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99215OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES A MEDICALLY APPROPRIATE HISTORY AND/OR EXAMINATION AND HIGH LEVEL OF MEDICAL DECISION MAKING. WHEN USING TIME FOR CODESELECTION, 40-54 MINUTES OF21127.402NANA3359Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96131PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR2122.802NANA3360Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT21176.602NANA3361Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96137PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN2122.802NANA3362Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR2122.802NANA3363Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90846FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT212.102NANA3364Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96136PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN2122.802NANA3365Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90839PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES1123.201NANA3366Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP MEDICAL PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)112401NANA3367Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION3800.61239.9038NANA3368Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT3500.57204035NANA3369Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99205OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES A MEDICALLY APPROPRIATE HISTORY AND/OR EXAMINATION AND HIGH LEVEL OF MEDICAL DECISION MAKING. WHEN USING TIME FOR CODE SELECTION, 60-74 MINUTES OF TOTAL T100115.601NANA3370Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90836PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN200.558.602NANA3371Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90832PSYCHOTHERAPY, 30 MINUTES WITH PATIENT50110.905NANA3372Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97154GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN300.671527.703NANA3373Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION1400.86124.3014NANA3374Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A7500.99491.7075NANA3375Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR20122.802NANA3376Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97158GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN300.331527.703NANA3377Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT2059.702NANA3378Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5652SUCTION SUSP AK/KNEE DISART1128.301NANA3379Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5649ISCH CONTAINMT/NARROW M-L SO1128.201NANA3380Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5845KNEE-SHIN SYS STANCE FLEXION1128.301NANA3381Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8480PROS SOCK SINGLE PLY AK1128.201NANA3382Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5981FLEX-WALK SYS LOW EXT PROSTH112201NANA3383Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8460SHRINKER ABOVE KNEE1128.201NANA3384Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5950ENDO AK ULTRA-LIGHT MATERIAL1128.201NANA3385Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5650TOT CONTACT AK/KNEE DISART S1128.201NANA3386Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.201NANA3387Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5652SUCTION SUSP AK/KNEE DISART1128.301NANA3388Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8480PROS SOCK SINGLE PLY AK1128.201NANA3389Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5649ISCH CONTAINMT/NARROW M-L SO1128.201NANA3390Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5845KNEE-SHIN SYS STANCE FLEXION1128.301NANA3391Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5968MULTIAXIAL ANKLE W DORSIFLEX1121.901NANA3392Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5981FLEX-WALK SYS LOW EXT PROSTH112201NANA3393Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8460SHRINKER ABOVE KNEE1128.201NANA3394Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5950ENDO AK ULTRA-LIGHT MATERIAL1128.201NANA3395Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5650TOT CONTACT AK/KNEE DISART S1128.201NANA3396Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.201NANA3397Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5652SUCTION SUSP AK/KNEE DISART10128.301NANA3398Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5649ISCH CONTAINMT/NARROW M-L SO10128.201NANA3399Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5845KNEE-SHIN SYS STANCE FLEXION10128.301NANA3400Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8480PROS SOCK SINGLE PLY AK10128.201NANA3401Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5981FLEX-WALK SYS LOW EXT PROSTH1012201NANA3402Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8460SHRINKER ABOVE KNEE10128.201NANA3403Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5950ENDO AK ULTRA-LIGHT MATERIAL10128.201NANA3404Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5650TOT CONTACT AK/KNEE DISART S10128.201NANA3405Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5920ENDO AK/HIP ALIGNABLE SYSTEM10128.201NANA3406Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3730.5634.7412.9592281OZEMPIC/RYBELSUSNA3407Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2420.7564.139.5665177DEPO-TESTOSTERONE/TESTOSTERONENA3408Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1970.89810.169.4630167FIRST-OMEPRAZOLE/OMEPRAZOLE/PRILOSECNA3409Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1470.7482.8915.6845102ADDERALL/AMPHETAMINE-DEXTROAMPHET/AMPHETAMINE-DEXTROAMPHETAMINE/AMPHETAMINE/DEXTROAMPHETAMINE/MYDAYISNA3410Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1470.7143.1210.519128PROTOPIC/TACROLIMUSNA3411Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1460.873.7812.455294HYDROCODONE/HYDROCODONE-ACETAMINOPHEN/HYDROCODONE-APAP/HYDROCODONE/ACETAMINOPHENNA3412Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1320.9320.536.926106PANTOPRAZOLENA3413Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1210.7777.8916.152794DULAGLUTIDE/TRULICITYNA3414Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1210.8767.9540.742596HUMIRANA3415Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1150.8170.297.442590ABSORICA/ACCUTANE/AMNESTEEM/CLARAVIS/ISOTRETINOIN/MYORISAN/ZENATANENA3416Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2517.7418.09916SKYRIZINA3417Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2211.7718.81616GABAPENTINNA3418Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2018.3815.88614OMEPRAZOLE/PANTOPRAZOLE/RABEPRAZOLENA3419Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1415.342.62410JANUMETNA3420Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA141016.31113AKLIEFNA3421Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9116.8609HIZENTRANA3422Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA912.660.0481CAPECITABINENA3423Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA710025ZALEPLONNA3424Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7100.0143RAMELTEONNA3425Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA610.9219.0215PROLIANA3426Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50141.3705STELARANA3427Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30160.1803ANDROGEL/TESTOSTERONENA3428Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3010.7142.4312HUMIRANA3429Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3012.230ELIQUISNA3430Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20152.622.7211TESTOSTERONENA3431Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20113.8520WEGOVYNA3432Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2010.5420ARMODAFINILNA3433Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2015.085.1811GRALISENA3434Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20135.6102SIMPONINA3435Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2010.2619.7511COSENTYXNA3436Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN1400.7195331109NANA3437Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)170.94122670215NANA3438Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)140.92861671212NANA3439Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)111266529NANA3440Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)110.90912969110NANA3441Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);91175736NANA3442Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)90.7778197336NANA3443Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue760Ancillary Services - Specialty Services-General Classification70.857112616NANA3444Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)60.83336706NANA3445Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)61175224NANA3446Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20930Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)111266529NANA3447Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);91175736NANA3448Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)61175224NANA3449Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)613206NANA3450Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed61143115NANA3451Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)518005NANA3452Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar515705NANA3453Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT69990Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)51134123NANA3454Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22600Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment41174522NANA3455Carrier F2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38770Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)41144913NANA3456Carrier F2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN14000.0071195331109NANA3457Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5050.9267144872433NANA3458Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)4310.9188164969362NANA3459Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66984Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation1320.9394216111121NANA3460Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level1310.9389164614117NANA3461Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)1160.663813408108NANA3462Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1040.69231736797NANA3463Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter.1020.362729763171NANA3464Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92250Fundus photography with interpretation and report910.96710702071NANA3465Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft910.87913273784NANA3466Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)830.91572267380NANA3467Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27096Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed5011837545NANA3468Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29877Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)1411480212NANA3469Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31276Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed1311565310NANA3470Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77067Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed12181012NANA3471Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0260Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography10189010NANA3472Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29824Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)915909NANA3473Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20930Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)81249817NANA3474Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31287Nasal/sinus endoscopy, surgical, with sphenoidotomy;715907NANA3475Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43242Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)71257525NANA3476Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63650Percutaneous implantation of neurostimulator electrode array, epidural718307NANA3477Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27784Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed1014310NANA3478Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27759Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage1014310NANA3479Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43254Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection1015201NANA3480Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64910Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve200.57402NANA3481Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67036Vitrectomy, mechanical, pars plana approach;200.52411911NANA3482Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15877Suction assisted lipectomy; trunk400.259704NANA3483Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99245Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.900.22222010072NANA3484Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58563Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)700.14298507NANA3485Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350Nipple/areola reconstruction1400.0714101014NANA3486Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99212Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 10-19 minutes of total time is spent on the date of the encounter.2200.04552985913NANA3487Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation100.7296837NANA3488Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem40.75148322NANA3489Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric20.56911211NANA3490Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0046Mental health services, not otherwise specified116910NANA3491Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0018Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem112401NANA3492Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0011Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)112601NANA3493Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0011Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)112601NANA3494Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0046Mental health services, not otherwise specified116910NANA3495Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0018Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem112401NANA3496Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem40.75148322NANA3497Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation100.7296837NANA3498Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric20.56911211NANA3499Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1430.8741275116127NANA3500Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education560.69642360353NANA3501Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem410.82931851635NANA3502Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan320.81252379230NANA3503Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session300.71865723NANA3504Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes300.83332376228NANA3505Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management270.62961559522NANA3506Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem250.762649619NANA3507Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2019Therapeutic behavioral services, per 15 minutes240.75073123NANA3508Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes230.869676023NANA3509Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96132Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour414604NANA3510Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; each additional hour (List separately in addition to code for primary procedure)314303NANA3511Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0373TAdaptive behavior treatment with protocol modification, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.2110302NANA3512Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96137Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure)215402NANA3513Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97154Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes215102NANA3514Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2012Behavioral health day treatment, per hour212202NANA3515Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)111901NANA3516Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour117401NANA3517Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96138Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes117401NANA3518Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96139Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure)117401NANA3519Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply390.666793039NANA3520Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)290.793191029NANA3521Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous positive airway pressure (CPAP) device220.409174022NANA3522Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each150.866713102213NANA3523Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable150.933313102213NANA3524Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA6550Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories140.928613100212NANA3525Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair component or accessory, not otherwise specified90.55565409NANA3526Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin90.88894809NANA3527Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7035Headgear used with positive airway pressure device80.1257108NANA3528Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1852Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf80.875215017NANA3529Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9342Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem7119316NANA3530Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section619006NANA3531Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0249Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include four tests519805NANA3532Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL0464Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment514.35214NANA3533Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1833Knee orthosis (KO), adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf519005NANA3534Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCV2624Polishing/resurfacing of ocular prosthesis518705NANA3535Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1392Portable oxygen concentrator, rental41137022NANA3536Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only418204NANA3537Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4153Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit318203NANA3538Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications319703NANA3539Carrier F2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL3913Hand-finger orthosis (HFO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment200.514202NANA3540Carrier F2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0240Bath/shower chair, with or without wheels, any size200.57302NANA3541Carrier F2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCB4153Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit300.33338203NANA3542Carrier F2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0667Segmental pneumatic appliance for use with pneumatic compressor, full leg400.25011222NANA3543Carrier F2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0652Pneumatic compressor, segmental home model with calibrated gradient pressure400.25011222NANA3544Carrier F2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS9342Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem700.142919316NANA3545Carrier F2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips230.60869.224320NANA3546Carrier F2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips230.60869.224320NANA3547Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN1090.6716.448.71891NANA3548Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent610.752440.1160NANA3549Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With490.6928.845.2742NANA3550Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy470.9447.5047NANA3551Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int420.861266.2240NANA3552Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom210.8650.5021NANA3553Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22634Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn1412454.5113NANA3554Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19328Removal Of Intact Breast Implant140.0724014NANA3555Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-Lateral,Ea Add.In140.6464.8014NANA3556Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim140.43068113NANA3557Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22634Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn1412454.5113NANA3558Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple131040112NANA3559Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75894Transcatheter Therapy Embolize Any Meth7104843NANA3560Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33340Percutaneous Transcatheter Closure Of The Left Atrial Appendage With Endocardial Implant,614006NANA3561Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem5128.805NANA3562Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, Combined Posterior Or Posterolateral Technique Wi/ Posterior Interbody Techni5124014NANA3563Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT42950Pharyngoplasty415404NANA3564Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22632Arthrodesis, Each Additional Interspace415404NANA3565Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50365Renal Homotxplnt,Implnt Gft;W/Recipnt Ne31803NANA3566Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent61012440.1160NANA3567Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy470147.5047NANA3568Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22634Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn14012454.5113NANA3569Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43235Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim1401068113NANA3570Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43659Unlisted Laparoscopy Procedure, Stomach1101037.729NANA3571Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total100145.3010NANA3572Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43845Gastric Restrictive Proc W/ Partial Gastrectomy, Pylorus-Preserving Duodenoileostomy & Ile50133.605NANA3573Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22632Arthrodesis, Each Additional Interspace4015404NANA3574Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61736Laser Interstitial Thermal Tx (Litt) Of Lesion, Intracranial, Incl Burr Hole(S), W/ Magnet2013602NANA3575Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echo, Transthoracic W/Doppler, Complete320930.972.43.82032073NANA3576Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous Airway Pressure (Cpap) Device [May Be Used For Either Cpap Or Apap]271680.971.7027168NANA3577Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Mri, Lower Extremity Any Joint; Wo Contr251610.931.94.96325098NANA3578Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Ct Abd & Pelvis240030.962.14.517423829NANA3579Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTMSMPTPhysical Therapy210690.69411NANA3580Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri Of Lumbar Spine182390.936.35.62318216NANA3581Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Of Brain And Further Sequences155470.971.73.62815519NANA3582Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity; Wo Co123030.9245.81812285NANA3583Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri Of Cervical Spine106910.932.45.91010681NANA3584Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551Mri Of Brain95090.962.55199490NANA3585Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74712Mri Fetal Sngl/1St Gestation10710.70107NANA3586Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70545Mra, Head, W/Contrast1011123.2299NANA3587Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ0585Injection, Onabotulinumtoxin A, 1 Unit4910049NANA3588Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74261Ct Colonography, Diag, W/O Dye4111.8041NANA3589Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64615Chemodenervation Of Muscle(S); Muscle(S) Innervated By Facial, Trigeminal, Cervical Spinal3410034NANA3590Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73206Cta Upr Extrm W/Wo Contrast3113.9031NANA3591Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72191Cta, Pelvis W/O Cntrst Flwd Cntrst2710027NANA3592Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81340Trb@ Gene Rearrange Amplify2413024NANA3593Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total229014.834.95224NANA3594Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple19101032.56185NANA3595Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15771Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar710135071NANA3596Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58570Tlh, Uterus 250 G Or Less69012443366NANA3597Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15772Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar420131.8042NANA3598Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36465Injection Of Non-Compounded Foam Sclerosant W/ Ultrasound Compression Maneuvers To Guide D410138041NANA3599Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22551Arthrodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytec3801072236NANA3600Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent330132033NANA3601Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37243Vascular Embolzatn Or Occlusion Incl Of All Rad Sup & Int Intraprocedural Roadmapping & Im32013.439.3725NANA3602Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation110.1820.763.456NANA3603Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem20.524.202NANA3604Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education1065.401NANA3605Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric1041.710NANA3606Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification1065.401NANA3607Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0010Alcohol And/Or Drug Services; Subacute Detoxification (Residential Addiction Program Inpat10001NANA3608Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0008Alcohol And/Or Drug Services; Subacute Detoxification (Hospital Inpatient)10001NANA3609Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services; Acute Detoxification (Residential Addiction Program Inpatien10001NANA3610Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem20.524.202NANA3611Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation110.1820.763.456NANA3612Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric1041.710NANA3613Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification1065.401NANA3614Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education1065.401NANA3615Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0010Alcohol And/Or Drug Services; Subacute Detoxification (Residential Addiction Program Inpat10001NANA3616Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0008Alcohol And/Or Drug Services; Subacute Detoxification (Hospital Inpatient)10001NANA3617Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services; Acute Detoxification (Residential Addiction Program Inpatien10001NANA3618Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0017Behavioral health; residential (hospital residential treatment program), without room and board, per diem200.524.202NANA3619Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation1100.1820.763.456NANA3620Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric10041.710NANA3621Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification10065.401NANA3622Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education10065.401NANA3623Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0010Alcohol And/Or Drug Services; Subacute Detoxification (Residential Addiction Program Inpat100001NANA3624Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0008Alcohol And/Or Drug Services; Subacute Detoxification (Hospital Inpatient)100001NANA3625Carrier H2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0011Alcohol And/Or Drug Services; Acute Detoxification (Residential Addiction Program Inpatien100001NANA3626Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin2580.876.954.510248NANA3627Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica2020.867852.44198NANA3628Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1760.833.543.911165NANA3629Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor1740.835659.88166NANA3630Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan930.732.458.31479NANA3631Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes930.7431.650.81875NANA3632Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session920.7316.553.81181NANA3633Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes900.7232.253.32169NANA3634Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem860.7217.145.3779NANA3635Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes790.7232.451.21861NANA3636Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156Family Adptve Bhvr Trtmnt Guidance, Admnstrd By Phys Or Other Qualified Hlth Care Profess9124918NANA3637Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153Adaptive Behavior Treatment By Protocol, Admnstrd By Tech Under The Direction Of A Phys Or9124918NANA3638Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151Behavior Identification Assessment, Administered By A Physician Or Other Qualified Health811208NANA3639Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155Adptve Bhvr Trtmnt W/ Protocol Modifictn, Admnstrd By Phys Or Other Qualified Hlth Care Pr812410.317NANA3640Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480Intensive Outpatient Psychiatric Services Per Diem7103316NANA3641Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours612806NANA3642Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870Electroconvulsive Therapy;1 Seizure21002NANA3643Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2014Skills Training And Development Per 15 Minutes112401NANA3644Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin258016.954.510248NANA3645Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica202017852.44198NANA3646Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor174015659.88166NANA3647Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCG2083Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patie440174.4451133NANA3648Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCG2082Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patie310182.745.21021NANA3649Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ3490Unclassified drugs300.3326.4121.921NANA3650Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan9300.0232.458.31479NANA3651Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97153Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes7900.0132.451.21861NANA3652Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97155Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes9000.0132.253.32169NANA3653Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97156Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes9300.0131.650.81875NANA3654Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Adjustable, Custom Fabricated, Includes Fitting And Adjustment2080.957.701329NANA3655Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified990.843099NANA3656Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ710.94056.9269NANA3657Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each480.9224105.4147NANA3658Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr410.8062.4140NANA3659Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications360.362487.2135NANA3660Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (Non-Invasive)320.254888.6329NANA3661Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination270.892436126NANA3662Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0606Aed Garment With Electrocardiogram Analysis260.5821.872242NANA3663Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8688Implt Nrostm Pls Gen Dua Non230.87109.4023NANA3664Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8691Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/Actuator, R9197.709NANA3665Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8694Auditory Osseointegrated Device, Transducer/Actuator, Replacement Only, Each8161.708NANA3666Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair Accessory, Headrest, Cushioned, Prefabricated, Including Fixed Mounting Hardwar6167.206NANA3667Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6549Gradient compression stocking/sleeve, not otherwise specified5160.405NANA3668Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply4132.8169.531NANA3669Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0277Alternating Pressure Mattress4104813NANA3670Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating312403NANA3671Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0265Hospital Bed, Total Electric (Head, Foot And Height Adjustments), With Any Type Side Rails315603NANA3672Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8687Implt Nrostm Pls Gen Dua Rec3110803NANA3673Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8681Pt Prgrm For Implt Neurostim3115603NANA3674Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0486Adjustable, Custom Fabricated, Includes Fitting And Adjustment208017.701329NANA3675Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8680Implantable Neurostimulator Electrode Each480124105.4147NANA3676Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications36012487.2135NANA3677Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0005Ultralightweight Wheelchair220158.7022NANA3678Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8614Cochlear Device/System1401112014NANA3679Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8691Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/Actuator, R90197.709NANA3680Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8694Auditory Osseointegrated Device, Transducer/Actuator, Replacement Only, Each80161.708NANA3681Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0986Manual Wheelchair Accessory, Push-Rim Activated Power Assist, Each4017204NANA3682Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0277Alternating Pressure Mattress40104813NANA3683Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL1844Ko, Single Upright, Thigh And Calf, With Adjustable Flexion And Extens3018003NANA3684Carrier H2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips1070.62931.22978NANA3685Carrier H2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips1070.62931.22978NANA3686Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47379UNLISTED LAPS PX LIVER20.50600020NANA3687Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY21000020NANA3688Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405REPLACEMENT AORTIC VALVE OPN2172240110NANA3689Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL HYSTERECTOMY11000010NANA3690Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21705REVISION OF NECK MUSCLE/RIB1001200010NANA3691Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33464VALVULOPLASTY TRICUSPID11000010NANA3692Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21175RECONSTRUCT ORBIT/FOREHEAD11000010NANA3693Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32662THORACOSCOPY W/MEDIAST EXC11000010NANA3694Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44205LAP COLECTOMY PART W/ILEUM11000010NANA3695Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHRD CMBN 1NTRSPC LUMBAR1003120010NANA3696Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY21000020NANA3697Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACEMENT AORTIC VALVE OPN2172240110NANA3698Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL HYSTERECTOMY11000010NANA3699Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33464VALVULOPLASTY TRICUSPID11000010NANA3700Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21175RECONSTRUCT ORBIT/FOREHEAD11000010NANA3701Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32662THORACOSCOPY W/MEDIAST EXC11000010NANA3702Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44205LAP COLECTOMY PART W/ILEUM11000010NANA3703Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240TRANSPLT ALLO HCT/DONOR11000100NANA3704Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37215TRANSCATH STENT CCA W/EPS110240010NANA3705Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43659UNLISTED LAPS PX STOMACH110240010NANA3706Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY3310133.100330NANA3707Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM310.839015100310NANA3708Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA280.82172419.503250NANA3709Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE160.9389656.602140NANA3710Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM140.7860222.900140NANA3711Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT36471NJX SCLRSNT MLT INCMPTNT VN140.8570330.900140NANA3712Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30-39 MIN130.6150127.400130NANA3713Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA120.8331257.602100NANA3714Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT36475ENDOVENOUS RF 1ST VEIN120.917066600120NANA3715Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION100.9031.200100NANA3716Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY3310133.100330NANA3717Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM260.839098.800260NANA3718Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA230.82196468.602210NANA3719Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE150.9389660.902130NANA3720Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36471NJX SCLRSNT MLT INCMPTNT VN120.857036800120NANA3721Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS RF 1ST VEIN110.9170717.800110NANA3722Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM110.7860117.800110NANA3723Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9299INJECTION, NIVOLUMAB1010962.70190NANA3724Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81162BRCA1&2 GEN FULL SEQ DUP/DEL10106000100NANA3725Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA100.83312390280NANA3726Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89356Reproductive Medicine10104800010NANA3727Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21139Head, Repair, Revision, and/or Reconstruction10103840010NANA3728Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43239Surgery Digestive System10109120010NANA3729Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22842Posterior segmental instrumentation1012400100NANA3730Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27096Injection procedure for sacroiliac joint1014800100NANA3731Carrier N2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASubstance Use Residential21122NANA3732Carrier N2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADetox11121NANA3733Carrier N2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASubstance Use Residential21122NANA3734Carrier N2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADetox11121NANA3735Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMH IP1012400100NANA3736Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMH RES1017200100NANA3737Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANACD RES1014800100NANA3738Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANASA RES1012400100NANA3739Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TCRANIAL MAGN STIM TX DELI50.664.125NANA3740Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BEHAVIOR TX PHYS/QHP20.536.232NANA3741Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYTX W PT 60 MINUTES11121NANA3742Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0015ALCOHOL AND/OR DRUG SERVICES11135.91NANA3743Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BHV ID ASSMT BY PHYS/QHP11126.151NANA3744Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS0201PARTIAL HOSPITALIZATION SERV11121NANA3745Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H1198.281NANA3746Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868TCRANIAL MAGN STIM TX DELI30.636.163NANA3747Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYTX W PT 60 MINUTES11121NANA3748Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPT BEHAVIOR TX PHYS/QHP10.572.151NANA3749Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015ALCOHOL AND/OR DRUG SERVICES11135.91NANA3750Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BHV ID ASSMT BY PHYS/QHP11126.151NANA3751Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0201PARTIAL HOSPITALIZATION SERV11121NANA3752Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H1198.281NANA3753Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151ABA10101920010NANA3754Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155MH OIF10101440010NANA3755Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXT AMB INFUSN PUMP INSULIN51050000NANA3756Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0466HOME VENT NON-INVASIVE INTER31030000NANA3757Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR20.667020000NANA3758Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8688IMPLT NROSTM PLS GEN DUA NON11010000NANA3759Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2599SGD ACCESSORY NOC11010000NANA3760Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2510SGD W MULTI METHODS MSG/ACCS11010000NANA3761Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT11010000NANA3762Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11010000NANA3763Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXT AMB INFUSN PUMP INSULIN51050000NANA3764Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0466HOME VENT NON-INVASIVE INTER31030000NANA3765Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR20.667020000NANA3766Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8688IMPLT NROSTM PLS GEN DUA NON11010000NANA3767Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2599SGD ACCESSORY NOC11010000NANA3768Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2510SGD W MULTI METHODS MSG/ACCS11010000NANA3769Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT11010000NANA3770Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11010000NANA3771Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA920.617.3156.4016760OZEMPIC 0.25 OR .5 PEN INJCTRNA3772Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA550.890.0990.64010450OZEMPIC 1/0.75 (3) PEN INJCTRNA3773Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA420.8131.5759.6014280NURTEC ODT 75 MG TAB RAPDISNA3774Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA3510.210.13019160ELIQUIS 5 MG TABLETNA3775Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA330.853.07155.8309240DEXCOM G6 EACH/DEXCOM G6 SENSOR EACHNA3776Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA330.820.0229.31010230TRULICITY 0.75MG/0.5 PEN INJCTRNA3777Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA290.863.94138.34013160STELARA 90 MG/ML SYRINGENA3778Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA270.345.99122.4108190DESCOVY 200MG-25MG TABLETNA3779Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA2610.5411.3705210HUMIRA(CF) PEN 40MG/0.4ML PEN IJ KITNA3780Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA240.792.8151.704200DEXCOM G6 EACH/DEXCOM G6 TRANSMITTER EACHNA3781Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA2610.5411.3705210HUMIRA(CF) PEN 40MG/0.4ML PEN IJ KITNA3782Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA2110.011.2904170TRULICITY 1.5 MG/0.5 PEN INJCTRNA3783Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA18116.3719.6904140DEXTROAMPHETAMINE-AMPHET ER 20 MG CAP.SR 24HNA3784Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1610.0242.9303130ENBREL SURECLICK 50MG/ML(1) PEN INJCTRNA3785Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1411.2843.4902120STELARA 45MG/0.5ML SYRINGENA3786Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1410.0112.0602120TRULICITY 3 MG/0.5ML PEN INJCTRNA3787Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1310.010.010490DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLETNA3788Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1213.0625.090930MENOPUR 75 UNIT VIALNA3789Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1110.133.0401100SKYRIZI PEN 150 MG/ML PEN INJCTRNA3790Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA101047.3100100OTEZLA 30 MG TABLETNA3791Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES4123.718.713NANA3792Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue367OPERATING ROOM SERVICES, KIDNEY TRANSPLANT4146.64NANA3793Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992211ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES2145.42NANA3794Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21662NANA3795Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT23586REFERRAL REHAB, ACUTE2102NANA3796Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue333RADIOLOGY, THERAPEUTIC AND/OR CHEMO ADMIN - RADIATION THERAPY2170.22NANA3797Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL212.950.611NANA3798Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4042MANAGEMENT OF OVULATION INDUCTION PER CYCLE1197.81NANA3799Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCD0501HISTOPATHOLOGIC EXAMINATIONS1101NANA3800Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCC1901C1901GUILLIAN BARRE WITH MOTOR >35.95.,COMORBIDITY IN TIER 21101NANA3801Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES4123.718.713NANA3802Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue367OPERATING ROOM SERVICES, KIDNEY TRANSPLANT4146.64NANA3803Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992211ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES2145.42NANA3804Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21662NANA3805Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23586REFERRAL REHAB, ACUTE2102NANA3806Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue333RADIOLOGY, THERAPEUTIC AND/OR CHEMO ADMIN - RADIATION THERAPY2170.22NANA3807Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL212.950.611NANA3808Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCD0501HISTOPATHOLOGIC EXAMINATIONS1101NANA3809Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCC1901C1901GUILLIAN BARRE WITH MOTOR >35.95.,COMORBIDITY IN TIER 21101NANA3810Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCC0305C0305NON-TRAUMATIC BRAIN INJURY M <42.50 AND A <78.50.COMORBIDITY IN TIER 2110.11NANA3811Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES4080.99514.335.726382NANA3812Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS2730.96347.536.413260NANA3813Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96040MEDICAL GENETICS COUNSELING EACH 30 MINUTES16610.521.1115.831621NANA3814Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ114130.7114NANA3815Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST107110.730.63968NANA3816Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES9318.345.1291NANA3817Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN810.975326.738.2378NANA3818Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0151SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN761376NANA3819Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST7417.924.32252NANA3820Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97810ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN720.819457.672NANA3821Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040MEDICAL GENETICS COUNSELING EACH 30 MINUTES16610.521.1115.831621NANA3822Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ114130.7114NANA3823Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST107110.730.63968NANA3824Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES9318.345.1291NANA3825Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0151SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN761376NANA3826Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST7417.924.32252NANA3827Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST721622.34131NANA3828Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD6613.836.6165NANA3829Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST64111.119.74123NANA3830Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS5511042.6253NANA3831Carrier E2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97810ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN7200.013957.672NANA3832Carrier E2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93306ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D1600.06252559.5115NANA3833Carrier E2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL900.11111.161.918NANA3834Carrier E2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCQ5103INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG600.166745.649.715NANA3835Carrier E2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23683EXT REFERRAL OBGYN500.2695NANA3836Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC41115.726392NANA3837Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP32142.512.8302NANA3838Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION20123.6383.41181NANA3839Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV12146.412NANA3840Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC10132.610NANA3841Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue154ROOM & BOARD, WARD - PSYCHIATRIC2124.22NANA3842Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES110.51NANA3843Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99220INITIAL OBSERVATION CARE/DAY 70 MINUTES1195.91NANA3844Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE110.21NANA3845Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION1150.11NANA3846Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC41115.726392NANA3847Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP32142.512.8302NANA3848Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION20123.6383.41181NANA3849Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV12146.412NANA3850Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC10132.610NANA3851Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue154ROOM & BOARD, WARD - PSYCHIATRIC2124.22NANA3852Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES110.51NANA3853Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99220INITIAL OBSERVATION CARE/DAY 70 MINUTES1195.91NANA3854Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE110.21NANA3855Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION1150.11NANA3856Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION5220.990441522NANA3857Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES106144.9106NANA3858Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN56150.256NANA3859Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE23115.783.9203NANA3860Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION18127.520.1171NANA3861Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS17148.538.7161NANA3862Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN15114.215NANA3863Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES13151.213NANA3864Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905BEHAVIORAL HEALTH TREATMENTS/SVCS, INTENSIVE OP, PSYCHIATRIC13126.413NANA3865Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97152BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN11137.511NANA3866Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES106144.9106NANA3867Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN56150.256NANA3868Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE23115.783.9203NANA3869Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION18127.520.1171NANA3870Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS17148.538.7161NANA3871Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN15114.215NANA3872Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES13151.213NANA3873Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue905BEHAVIORAL HEALTH TREATMENTS/SVCS, INTENSIVE OP, PSYCHIATRIC13126.413NANA3874Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97152BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN11137.511NANA3875Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN10130.410NANA3876Carrier E2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION52100.001941521NANA3877Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S160112.317.55155NANA3878Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1330.9854.917.115118NANA3879Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR1210.99179.510.78113NANA3880Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR860.98847.9261076NANA3881Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION81127.981NANA3882Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE71150.971NANA3883Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2810.315.3127NANA3884Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0693UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL23123.923NANA3885Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1846KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM22177.922NANA3886Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP2215.713.6418NANA3887Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S160112.317.55155NANA3888Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION81127.981NANA3889Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE71150.971NANA3890Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2810.315.3127NANA3891Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0693UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL23123.923NANA3892Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1846KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM22177.922NANA3893Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP2215.713.6418NANA3894Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0691UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS22143.222NANA3895Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7005NONDISPOSABLE NEBULIZER SET2015.220NANA3896Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1900AFO SPRNG WIR DRSFLX CALF BD191107.619NANA3897Carrier E2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0651PNEUM COMPRESSOR SEGMENTAL300.333360.23NANA3898Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou670.388129.267NANA3899Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE43190.443NANA3900Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL28194.728NANA3901Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4211SUPP FOR SELF-ADM INJECTIONS23122.810.3122NANA3902Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21135.621NANA3903Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN151129.815NANA3904Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA6257TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS31408.43NANA3905Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4456ADHESIVE REMOVER WIPES ANY TYPE EACH213312NANA3906Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1129.81NANA3907Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL110.11NANA3908Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE43190.443NANA3909Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL28194.728NANA3910Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4211SUPP FOR SELF-ADM INJECTIONS23122.810.3122NANA3911Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21135.621NANA3912Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN151129.815NANA3913Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6257TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS31408.43NANA3914Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4456ADHESIVE REMOVER WIPES ANY TYPE EACH213312NANA3915Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1129.81NANA3916Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL110.11NANA3917Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou670.388129.267NANA3918Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou6700.014929.267NANA3919Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1220.819723.9115573801220EMPAGLIFLOZINNA3920Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA660.469730.936603540660VARENICLINE TARTRATENA3921Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA570.964918.109293370570UBROGEPANTNA3922Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA510.647117.958186270510INSULIN GLARGINENA3923Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA49129.887551020490RIVAROXABANNA3924Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA450.488925.214666670450SEMAGLUTIDENA3925Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA400.97513.007409720400SECUKINUMABNA3926Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA390.974417.964700850390FREMANEZUMAB-VFRMNA3927Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA350.628627.687111110350LISDEXAMFETAMINE DIMESYLATENA3928Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA35114.157507940350ADALIMUMABNA3929Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA49129.887551020490RIVAROXABANNA3930Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA35114.157507940350ADALIMUMABNA3931Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA28176.13976190280TICAGRELORNA3932Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA11121.822575760110GALCANEZUMAB-GNLMNA3933Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10110.724916670100GUSELKUMABNA3934Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5112.0475050VORTIOXETINE HBRNA3935Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5128.54044444050BREXPIPRAZOLENA3936Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4117.31354167040ABATACEPTNA3937Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4137.44520833040EMTRICITABINE-TENOFOVIR ALAFENAMIDE FUMARATENA3938Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA318.633796296030LACOSAMIDENA3939Carrier E2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA5100.019617.958186270510INSULIN GLARGINENA3940Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD110800.992218241106020NANA3941Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD770.9737153761NANA3942Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV400.95224139NANA3943Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV2516025NANA3944Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST190.8947916316NANA3945Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533CABG USING ART GRFTS 1 ART GRFT150.8210510NANA3946Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU150.82595411NANA3947Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY130.92311.511211NANA3948Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT35301THROMBOENDARTECTMY NECK,NECK INCIS110.818214011NANA3949Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO90.777893136NANA3950Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV2516025NANA3951Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551ARTHRODESIS ANT INTERBODY CERVICAL BELOW C271183516NANA3952Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663THORACOSCOPY SURG W/ LOBECTOMY TOTAL/SEGMEN713907NANA3953Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT762MISC SERVICES619360NANA3954Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32650THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA6101.524NANA3955Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59410VAG DELIVERY ONLY W/ POSTPARTUM CARE41004NANA3956Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59514CESAREAN DELIVERY ONLY410713NANA3957Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY314403NANA3958Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239UPPER GI ENDO W/ BX SINGLE/MULT318403NANA3959Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43280LAP,ESOPHAGOGAST FUNDOPLASTY312403NANA3960Carrier C2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT120ROOM AND BOARD1108000.000118241106020NANA3961Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS923710.96774.713.6967982692NANA3962Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES112940.93686.317.639110903NANA3963Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE103970.98761718310214NANA3964Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT70420.974614.53426700NANA3965Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES47480.992817447471NANA3966Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER23820.97362.7142632119NANA3967Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235UPPER GI ENDO DX (SEP PROC)19450.963515.51791766NANA3968Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS19420.91977293341608NANA3969Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERA ACTVI DIRECT PAT CONTACT EA 15 MIN17470.95258.522.3881659NANA3970Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN16290.96385.316.3771552NANA3971Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58300INSERT INTRAUTERINE DEVICE136124.731105NANA3972Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ3301TRIAMCINOLONE ACETONIDE INJ PER 10 MG12611205121NANA3973Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92523EVALUATION OF SPEECH SOUND PRODUCTION W/EVAL LANG COMP/EXPRESSION114108.71113NANA3974Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17260DESTRUCT MALIG LES TRUNK/ARM/LEG < 0.5 CM11210.62.58104NANA3975Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT51798MEASUREMENT PVR URIN&/BLADD CAPACTY US NON-IMAG92148290NANA3976Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92526TX SWALLOWING DYSFUNCTION &/OR ORAL FUNCTION FEED681435.4761NANA3977Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95115PROFES SVC IMMUNOTHER NON-PROV EXTRACT SINGLE INJ6510.311.3362NANA3978Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77001FLUORO GUIDE FOR CENT VENOUS ACCESS DEVICE6215.471151NANA3979Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT559OTHER THERAPY SERV591158.5059NANA3980Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92960CARDIOVERSION ELECTIVE EXT5710.591047NANA3981Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT50688CHANGE URETEROSTOMY TUBE1011901NANA3982Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT62380ENDO DECOMPRESS NEURAL ELEMNTS/EXCIS HERNIATD DISK, 1 INTERSPACE, LUMBAR200.516802NANA3983Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70545MAGNETIC RESONANCE ANGIO, HEAD W/DYE200.512502NANA3984Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT76390MRI SPECTROSCOPY200.56502NANA3985Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27822TRIMALLEOLAR FX W/WO FIX W/O FIX POST LIP OP TX400.252422NANA3986Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22513PERCUTANEOUS VERTBRAL AUGMENT, UNILATRL OR BILAT CANNULATION; THORACIC500.224.33932NANA3987Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61885INSRT/REDO NEUROSTIM 1 ARRAY500.216124.323NANA3988Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT66991XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+1000.20.564.828NANA3989Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81455TGSAP SO/HEMATOLYMPHOID NEO/DO 51/<DNA/DNA&RNA600.16673.548.824NANA3990Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78830LOCLZJ TUM SPECT W/CT 1 AREA/ACQUISJ 1DAY IMG800.12513.577.326NANA3991Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ROOM AND BOARD5690.98427.3115672NANA3992Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3450.982629173432NANA3993Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV3330.98522343321NANA3994Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ROOM AND BOARD1530.9935141530NANA3995Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD115810NANA3996Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD115810NANA3997Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ROOM AND BOARD1530.9935141530NANA3998Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV3330.98522343321NANA3999Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ROOM AND BOARD5690.98427.3115672NANA4000Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3450.982629173432NANA4001Carrier C2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT124ROOM AND BOARD56900.00537.3115672NANA4002Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT108300.99633826910561NANA4003Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS31060.9974551063000NANA4004Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY7240.99596.668716NANA4005Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES5940.99165.516.725569NANA4006Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS2840.92611081807277NANA4007Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR2440.97546.714.33241NANA4008Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT2110.772561.70211NANA4009Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS1520.815847.81406146NANA4010Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS1270.99211.352125NANA4011Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS127129.23124NANA4012Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS127129.23124NANA4013Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES4714326146NANA4014Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT18121018NANA4015Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT617306NANA4016Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT414513NANA4017Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN213.502NANA4018Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806IND PSYCHOTHERAPY OFFICE 45-50 MIN11801NANA4019Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96131PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; EA ADDL HOUR111801NANA4020Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96136PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS113801NANA4021Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96138PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS1113701NANA4022Carrier C2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG2082VISIT FOR EVAL/MGMT EST PT REQ SUPERVISOIN MD, UP TO 56 MG OF ESKETAMINE NASAL, SELF ADMIM2300.04358859.3320NANA4023Carrier C2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT21100.037961.70211NANA4024Carrier C2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT1083000.00013826910561NANA4025Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE45520.986617.5984454NANA4026Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE44160.93611.528.48943522NANA4027Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE20210.99361.2241876145NANA4028Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL11410.97021.323736405NANA4029Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT6870.97671.714333354NANA4030Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT6870.9942811.73684NANA4031Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR6240.99251621603NANA4032Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH5240.97142.328176348NANA4033Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE4780.97912.311.4148330NANA4034Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP4380.99090.611.39429NANA4035Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND371187.32369NANA4036Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR24710.51018463NANA4037Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4670AUTOMATIC BP MONITOR DIAL12910.7613116NANA4038Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4338INDWELLING CATH LATEX1181168434NANA4039Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4387WALKING BOOT, PREFAB, NONPNEUMATIC821159181NANA4040Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4397PLANTAR FASCITIS NIGHT SPLINT4718.4047NANA4041Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB4411.413836NANA4042Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0849TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE4310.111142NANA4043Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0484OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEV, NONELEC, ANY TYPE, EACH4113.621.31724NANA4044Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1951AFO, SPIRAL, PLASTIC OR OTHER, PREFAB41117041NANA4045Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA5512FOR DIAB ONLY MX DNSITY INSRT DIR FORMD PRFAB EA300.66672603NANA4046Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5321AK OPEN END SACH400.256704NANA4047Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5981ALL LE PROSTHESES600.166710006NANA4048Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0766ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE1000.13.714537NANA4049Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4160ENTERAL FORMULA, PEDS, NUTRITIONALLY COMP CALORIE DENSE, 100 CAL = 1 UNIT1700.0588108.3017NANA4050Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL3000FOOT INSERT REMOV MOLDED TO PT15400.0065840.65149NANA4051Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0470RESP ASSIST DEV, BI-LEVEL PRESSRE CAPABL, W/O BACK UP RATE FEATURE, NONINVAS19000.00531.531.746144NANA4052Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2402NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE20400.004921.779.617628NANA4053Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0001WHEELCHAIR STANDARD27700.0036219104173NANA4054Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL114100.00091.322.8736405NANA4055Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS16340.96942.615.61111523NANA4056Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES8570.75037.361.7312545NANA4057Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN4940.959561320474NANA4058Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE2170.9447529.64213NANA4059Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE1610.97521.53514219NANA4060Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG1130.9646628.63083NANA4061Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD109113.41090NANA4062Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1060.801911872799NANA4063Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV950.9579631.51580NANA4064Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9276SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL760.9079152.33739NANA4065Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD109113.41090NANA4066Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA4511.315.52421NANA4067Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95249GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING20111.6020NANA4068Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0403TPREV BEHAVIOR CHANGE, INTENS DIAB PRGRM TO INDIVIDUAL IN A GRP SETTING, MINIMUM 60 MIN, PR DY19154.4019NANA4069Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT762MISC SERVICES15119.3150NANA4070Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67210DESTRUCT LOCALIZED RET LES 1+ SESS PHOTOCOAGULA10173928NANA4071Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH912309NANA4072Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ2778LUCENTIS 0.1MG, INJECTION910.12618NANA4073Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95251GLUC MNTR CONT REC FROM NTRSTL TISS FLU, ANALYSIS/INTERP/REP7145.607NANA4074Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE7115.607NANA4075Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES85700.00237.361.7312545NANA4076Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD44620.986118.432444517NANA4077Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV291623128NANA4078Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD27123270NANA4079Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU90.8889299118NANA4080Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533CABG USING ART GRFTS 1 ART GRFT810.71535NANA4081Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV810417NANA4082Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y716007NANA4083Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY60.5411115NANA4084Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY6111624NANA4085Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992211ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES6101415NANA4086Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV291623128NANA4087Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD27123270NANA4088Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33533CABG USING ART GRFTS 1 ART GRFT810.71535NANA4089Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV810417NANA4090Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y716007NANA4091Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY6111624NANA4092Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992211ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES6101415NANA4093Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32666THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT511.53523NANA4094Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO5130.523NANA4095Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST513605NANA4096Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS239910.9911320241521576NANA4097Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES28510.98354.720.71232728NANA4098Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES22020.990915.6422011NANA4099Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE17790.9899414.5341745NANA4100Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT14200.9944171101310NANA4101Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,8280.751214.755117711NANA4102Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER8090.992621968741NANA4103Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JOINT6250.859694658567NANA4104Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72158MRI LUMBAR W/WO CONTRST SPINE6190.3327.793.361558NANA4105Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL5950.8021040.7132463NANA4106Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77080DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE27210.21915257NANA4107Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY22512.41218207NANA4108Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17311MOHS HD, NCK, HND, FEET, GEN 1ST STGE UP TO 5 BLCK16011.31229131NANA4109Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CAT REM W/ INSERT LENS PROSTHESIS; W/O ECP1581320.519139NANA4110Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378COLONOSCOPY DX W/WO SPEC/COLON DECOMP (SEP PROC)991324198NANA4111Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17000DESTRUCT 1ST AK PREMALIG LESION9212.720.4389NANA4112Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29881KNEE SCOPE,MED/LAT MENISECTOMY W/DEBRIDE/CHONDRO881116385NANA4113Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213OFFICE VISIT E&M EST PT, LOW MDM, 20-29 MINS871233.5384NANA4114Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20610ARTHROCENTESIS ASP/INJ MAJOR JNT/BURSA, WITHOUT ULTRASOUND GUIDANCE.7012.432763NANA4115Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95863EMG NEEDLE 3 EXTREMITIES W/WO RELATED PARASPINAL691115564NANA4116Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT10060I & D ABSCESS SIMP/SINGLE400.251460.522NANA4117Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15830EXCISION, EXCESS SKIN & SUBQU TISSUE, ABDOMEN500.2122.405NANA4118Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63685INSRT/REDO SPINE N GENERATOR500.26505NANA4119Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77387GUIDANCE LOCALIZTION TARGET VOLUME DELIVERY RADIATION TX600.1667104224NANA4120Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT54161CIRCUMCISION SURG EXC NOT CLAMP EXCEPT NEWBORN800.125358.317NANA4121Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81229CYTOGENOM CONST MICROARRAY COPY NUMBER&SNP VAR900.1111488.336NANA4122Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99183PHYSICN ATTENDNCE HYPERBARIC OXYGEN THERAPY900.111110009NANA4123Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78816TUMOR IMAGE PET/CT FULL BODY1000.19597.719NANA4124Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70336MRI TEMPOROMANDIBULAR JOINT1400.07141150311NANA4125Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0402TCOLLAGEN CROSS-LINKING OF CORNEA1700.05881766215NANA4126Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ROOM AND BOARD2680.9925512671NANA4127Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD1570.9936291570NANA4128Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV143131.61430NANA4129Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ROOM AND BOARD41111410NANA4130Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD11710NANA4131Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV143131.61430NANA4132Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ROOM AND BOARD41111410NANA4133Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD11710NANA4134Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD1570.9936291570NANA4135Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ROOM AND BOARD2680.9925512671NANA4136Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT12430.99521.513.6631180NANA4137Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS4290.99774331398NANA4138Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES1690.982248.59160NANA4139Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS850.9176180085NANA4140Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY7518.7075NANA4141Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT720.736176.6072NANA4142Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR5216118151NANA4143Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS510.8431170051NANA4144Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS38115137NANA4145Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR370.9189113.7136NANA4146Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY7518.7075NANA4147Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR5216118151NANA4148Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS38115137NANA4149Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96136PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS714707NANA4150Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE514605NANA4151Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99492INIT PSYCHIATRIC COLLABORATIVE CARE MGMT, FIRST 70 MINS/FIRST CAL MONTH2110802NANA4152Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ2315NALTREXONE, DEPOT FORM, 1 MG INJECTION212602NANA4153Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS11001NANA4154Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; EA ADDL HOUR1124601NANA4155Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96138PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS110.501NANA4156Carrier D2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT7200.0476.6072NANA4157Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE16640.95921.423.71861478NANA4158Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE10900.987211291081NANA4159Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE7060.99581.52463769NANA4160Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT3530.96880.2152351NANA4161Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR3010.9701214.45296NANA4162Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL2600.953822616793NANA4163Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP2170.9447170217NANA4164Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND2120.9858180212NANA4165Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT2020.9653224.410399NANA4166Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA1810.977915151180NANA4167Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE9912.715.53168NANA4168Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN891128.6683NANA4169Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR6411.67.64519NANA4170Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0935PASSIVE EXERCISE DEVICE48123048NANA4171Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1820KO ELAS W/ CONDYLE PADS & JO42113.5042NANA4172Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4387WALKING BOOT, PREFAB, NONPNEUMATIC41111041NANA4173Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0431PORTABLE GASEOUS 02391419.52613NANA4174Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1852KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH/CALF, PREFAB, OFF-THE-SHELF361319.7630NANA4175Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8030DME BREAST PROTHESIS ONLY361615333NANA4176Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB3211.422329NANA4177Carrier D2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE8000GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT INCL ALL ACCESSORIES & COMP200.58502NANA4178Carrier D2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0739REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS3500.05713679.7530NANA4179Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS4630.98722140423NANA4180Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES3470.729111.377135212NANA4181Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN1480.99322.62711137NANA4182Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE690.95650.328.7168NANA4183Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG631328.5855NANA4184Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP480.62512.594642NANA4185Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE471215398NANA4186Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD41112.4410NANA4187Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG340.9412725430NANA4188Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV331248.6528NANA4189Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG631328.5855NANA4190Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE471215398NANA4191Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD41112.4410NANA4192Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV331248.6528NANA4193Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA10132655NANA4194Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT762MISC SERVICES9128.390NANA4195Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67228DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN910.53527NANA4196Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95249GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING812508NANA4197Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH810.410526NANA4198Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11042DEBRIDE SKIN & SUBQ TISSUE7171.707NANA4199Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERN AMBUL INSULIN INFUS PUMP4800.041712.594642NANA4200Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT MATERIAL ATTACHED TO SPINE110.7273141.4600110NANA4201Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT TO BONE DURING SPINAL SURGERY101143.2900100NANA4202Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853METALLIC MESH BETWEEN VERTEBRAE9172.440090NANA4203Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44620CLOSURE OF INTESTINAL DIVERSION6115.2174.20240NANA4204Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPIC PARTIAL REMOVAL OF COLON6191.510060NANA4205Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533CORONARY ARTERY BYPASS WITH ARTERIAL GRAFT; 1 ARTERY6112.1559.660150NANA4206Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9000DOXORUBICIN HCL INJECTION6155.9564.60240NANA4207Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK5165.860050NANA4208Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECOMY WITH TUBES AND OVARIES5126.6111.280140NANA4209Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614SPINAL FUSION TO JOIN TWO VERTEBRAE51200.190050NANA4210Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61700SURGERICAL TREATMENT OF SIMPLE ANEURYSM THRU THE INTRACRANIAL CAROTID ARTERY1149.90010NANA4211Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5119INJ RITUXIMAB-PVVR BIOSIMILAR RUXIENCE 10 MG4195.72610130NANA4212Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663SCOPE OF LUNGS WITH REMOVAL OF LOBE11125.970010NANA4213Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13102COMPLEX REPAIR OF WOUND TO TRUNK 5CM OR LESS11154.880010NANA4214Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33871TRANSVERSE AORTIC-ARCH GRAFT WITH CARDIAC BYPASS PREFERRED HYPOTHERMIA11100.230010NANA4215Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15002SURG PREP/CREAT RECIP SITE BY EXCIS OPEN WOUNDS/BURN/SCAR 1ST 100 SQ CM11142.880010NANA4216Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61782SCAN PROCEDURE CRANIAL ADDON2124.7142.350110NANA4217Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15738SKIN FLAP FROM LOWER EXTREMITY TO TREAT ANOTHER AREA OF BODY1163.580010NANA4218Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2260MILRINONE LACTATE PER 5 ML113.270100NANA4219Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE21133.280020NANA4220Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT24341TENDON/MUSCLE WOUND REPAIR TO UPPER ARM OR ELBOW101154.880010NANA4221Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19371PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE101142.880010NANA4222Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS2068REMOVAL OF CAPSULE OR SCAR TISSUE AROUND BREAST IMPLANT101142.880010NANA4223Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT13102COMPLEX WOUND REPAIR TO TRUNK EACH ADDL 5 CM101154.880010NANA4224Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT49568HERNIA REPAIR WITH MESH101142.880010NANA4225Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15002SURGICAL PREPRATION TO RECEIVE SKIN GRAFT SITE DUE TO OPEN WOUNDS/BURN/SCAR 1ST 100 SQ CM101142.880010NANA4226Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT13101COMPLX WOUND REPAIR TO TRUNK; 2.6 CM TO 7.5 CM101142.880010NANA4227Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19328REMOVAL INTACT BREAST IMPLANT101142.880010NANA4228Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350NIPPLE/AREOLA RECONSTRUCTION101142.880010NANA4229Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15003WOUND PREP ADDITIONAL AREA OF 100 CM101142.880010NANA4230Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN1060.669881.53124.790.0331022NANA4231Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD1050.5524141.6201050NANA4232Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483ANESTHETIC AGEN AND/OR STERIOD INJECTION FOR TRANSFORAMINAL EPIDURAL INJECTION INTO A SINGLE LEVEL1000.91114.060.0301001NANA4233Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE810.432119.11164.611800NANA4234Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION,ONABOTULINUMTOXINA670.74632.1100.391660NANA4235Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue551SKILLED NURSE VISIT IN HOME66125.4187.062640NANA4236Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81162GENETIC TESTING FOR GENE DELETIONS OR DNA REPAIR-ASSOCIATED GENE470.6596161.420460NANA4237Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447REPAIR PROCEDURES ON THE FEMUR AND KNEE JOINT460.891360.920460NANA4238Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-14440.1591115.240420NANA4239Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-7440.1591116.740420NANA4240Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT69930COCHLEAR DEVICE IMPLANT WITH/WITHOUT MASTOID11192.52010NANA4241Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9181ETOPOSIDE INJECTION515.027.29140NANA4242Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ1756INJECTION IRON SUCROSE 1 MG1158.22100NANA4243Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99205OFFICE/OUTPATIENT VISIT NEW111.04010NANA4244Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27488REMOVAL TOTAL KNEE PROSTHETIC CEMENT WITH/WITHOUT SPACER1119.92010NANA4245Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MANAGEMENT 30-39 MIN5186.19050NANA4246Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30140SUBMUCOUS RESECTION OF THE INFERIOR TURBINATE PARTIAL ORCOMPLETE ANY METHOD1155.4010NANA4247Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99215OFFICE/OUTPATIENT VISIT ESTABLISHED11145.12010NANA4248Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64714REVISION OF LOW BACK NERVE(S)1122.3010NANA4249Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99349HOME VISIT ESTABLISHED PATIENT41165.38040NANA4250Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77063X-RAY EXAM MOUTH JOINTS OPEN AND CLOSED, BILATERALLY101000NANA4251Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15830SURGICAL REMOVAL OF EXCESS SKIN AND SUBCUTANEOUS TISSUE OF THE ABDOMEN1010.09010NANA4252Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70330X-RAY EXAM MOUTH JOINTS OPEN AND CLOSED, BILATERALLY101167.9010NANA4253Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHOLOGICAL DIAGNOSTIC EVALUATION1010.02001NANA4254Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77067SCREENING MAMMOGRAPHY101000NANA4255Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90834PSYCHO THERAPY INDIVIDUAL/FAMILY 45 MINUTES101000NANA4256Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64566ELECTRICAL STIMULATION TO THE POSTERIOR TIBIAL NERVE WITH NEEDLE ELECTRODE200.5259.75020NANA4257Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT98941CHIROPRACTIC MANIPULATIVE TREATMENT TO; SPINAL 3-4 REGIONS200.5331.18010NANA4258Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ1602GOLIMUMAB FOR IV USE 1MG300.3333170.58030NANA4259Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37243PARTIAL/COMPLETE BLOCK OF VASULARE BLOOD FLOW TO AN ORGAN400.25243.61040NANA4260Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY570.9825020.2800570NANA4261Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY451012.2100450NANA4262Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED241038.4800200NANA4263Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC91018.290090NANA4264Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue100ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY1107.630010NANA4265Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED241038.4800200NANA4266Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC91018.290090NANA4267Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue100REMOVL EMBEDDED FB CONJUNCT INCI1107.630010NANA4268Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY451012.2100450NANA4269Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY570.9825020.2800570NANA4270Carrier B2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY5700.0175020.2800570NANA4271Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY1610114.620140NANA4272Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES131053.940120NANA4273Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT1010110.730.10101NANA4274Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM91024.93090NANA4275Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS61027.82060NANA4276Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR51024.02050NANA4277Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY41053.19040NANA4278Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM31072.25030NANA4279Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES21037.33020NANA4280Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN21072.74020NANA4281Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue901BEHAVIORAL HEALTH TREATMENT SERVICES, ELECTROSHOCK11071.97010NANA4282Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM31072.25030NANA4283Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN21072.74020NANA4284Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY1610114.620140NANA4285Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR51024.02050NANA4286Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870PSYCHOTHERAPY SESSION UNDER 60 MINUTES41053.19040NANA4287Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES21037.33020NANA4288Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM91024.93090NANA4289Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015IOP AL &/OR DRG SRV->=3HRS DA/3DAWK110000NANA4290Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT1010110.730.10101NANA4291Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE2820.953919.7490.26022770NANA4292Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR710.929656.951.8706630NANA4293Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS380.921187.7800380NANA4294Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP240.95832.39139.9801220NANA4295Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP180.944467.25102.2901170NANA4296Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE8197.10070NANA4297Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP7189.580060NANA4298Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR70.714314.6967.130340NANA4299Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM6199.240060NANA4300Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604HOSP GRADE ELECTRIC BREAST PUMP30.6667102.690030NANA4301Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005ULTRALIGHTWEIGHT WHEELCHAIR1171.30010NANA4302Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2202MANUAL WHEELCHAIR NON-STANDARD SEAT FRAME WIDTH, 24-27 INCHES11223.020100NANA4303Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9342HOME THERAPY1122.170100NANA4304Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9279MONITOR FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, NOT OTHERWISE CLASSIFIED11286.140010NANA4305Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2611GENERAL WHEELCHAIR BACK CUSSION WIDTH < 22 INCHES, ANY HEIGHT MOUNT HARDWARE1171.290010NANA4306Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM6199.240060NANA4307Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0835POWER WHEEL CHAIR, GROUP 2 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK,11124.030010NANA4308Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260HOSPITAL BED SEMI-ELEC WITH ANY RAILS WITH MATTRESS2121.7390.120110NANA4309Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0637COMBINATION SIT TO STAND SYSTEM11285.970010NANA4310Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP7189.580060NANA4311Carrier B2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS3800.026387.7800380NANA4312Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY780.974440.1793.7201770NANA4313Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY130.8462137.5800130NANA4314Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING110.9091124.6200110NANA4315Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM8188.30080NANA4316Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME40122.190040NANA4317Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN4174.10040NANA4318Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY30124.780030NANA4319Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN4174.10040NANA4320Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM8188.30080NANA4321Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY780.974440.1793.7201770NANA4322Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING110.9091124.6200110NANA4323Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY130.8462137.5800130NANA4324Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY30124.780030NANA4325Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME40122.190040NANA4326Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG160.68754.775.5115NANA4327Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC130.61543.867.7211NANA4328Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP120.91671157.848NANA4329Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048LAM FACETECTOMY and FORAMOT 1 VRT SGM EA ADDL SGM100.73.899.828NANA4330Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE90.777822.117.218NANA4331Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22600ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT90.77783.887.427NANA4332Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST90.777823.919.927NANA4333Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38724CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ90.666724.94027NANA4334Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9100INJECTION CYTARABINE 100 MG80.7515.257.444NANA4335Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY80.87518.121.444NANA4336Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION13162.513NANA4337Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558ARTHRD ANT INTERBODY MIN DSC LUMBAR7175.27NANA4338Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49000EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX6111.31442NANA4339Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95961FUNCJAL CORT and SUBCORT MAPG PHYS/QHP ATTND INIT HR6120.645.933NANA4340Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620CLOSURE ENTEROSTOMY LG/SMALL INTESTINE4133.198.122NANA4341Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13101REPAIR COMPLEX TRUNK 2.6-7.5 CM3126.158.512NANA4342Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13102REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM OR LT3126.158.512NANA4343Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15002PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT3126.158.512NANA4344Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15003PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT3126.158.512NANA4345Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE3172.63NANA4346Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23440RESECTION/TRANSPLANTATION LONG TENDON BICEPS10196.21NANA4347Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT50949UNLISTED LAPAROSCOPY PROCEDURE URETER10118.21NANA4348Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58146MYOMECTOMY 5 OR GT MYOMAS and OR GT 250 GM ABDOMINA10142.61NANA4349Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61458CRNEC SOPL EXPL/DCMPRN CRNL NRV10151.11NANA4350Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT44626CLSR NTRSTM LG/SM RESCJ and COLORECTAL ANASTOMOSIS200.54825.611NANA4351Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT52351CYSTO W/URTROSCOPY and /PYELOSCOPY DX200.518.273.611NANA4352Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT92652AEP THRESHOLD ESTIMATION MLT FREQUENCIES I and R300.333321.237.512NANA4353Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT47135LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE300.333319.2150.112NANA4354Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58140MYOMECTOMY 1-4 MYOMAS W/250 GM OR LT ABDOMINAL APPR300.333346.33NANA4355Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT44620CLOSURE ENTEROSTOMY LG/SMALL INTESTINE400.2533.198.122NANA4356Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC and COLR D14150.90049.345.4281387NANA4357Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT78452MYOCARDIAL SPECT MULTIPLE STUDIES2610.900458.83258NANA4358Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93015CV STRS TST XERS and /OR RX CONT ECG W/SI and R2320.8707148.92230NANA4359Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93971DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY1970.913714.522.123174NANA4360Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77334TX DEVICES DESIGN AND CONSTRUCTION COMPLEX1710.92413.218.765106NANA4361Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93350ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST and ST1690.89942940.33166NANA4362Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT ABDOMEN and PELVIS W/CONTRAST MATERIAL1500.890927.336.645105NANA4363Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585BOTULINUM TOXIN TYPE A PER UNIT1570.80257.463.110147NANA4364Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-1480.9085043.71147NANA4365Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93248EXTERNAL ECG REC GT 7D LT 15D REVIEW and INTERPRETATION1460.917860.5146NANA4366Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93271XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS321032NANA4367Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93975DUP-SCAN ARTL FLO ABDL/PEL/SCROT and /RPR ORGN COM28148.1226NANA4368Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93229XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT24124NANA4369Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93280PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER241024NANA4370Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93460R AND L HRT CATH WINJX HRT ART AND L VENTR IMG191019NANA4371Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9502TECHNETIUM TC-99M TETROFOSMIN DX PER STUDY DOSE18126.818NANA4372Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93295INTERROGATION EVAL REMOTE LT 90 D 1/2/MLT LD DFB171017NANA4373Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77470SPECIAL TREATMENT PROCEDURE13122.1211NANA4374Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93451RIGHT HEART CATH O2 SATURATION AND CARDIAC OUTPUT13140.9112NANA4375Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93990DUPLEX SCAN HEMODIALYSIS ACCESS131112NANA4376Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT17999UNLISTED PX SKIN MUC MEMBRANE AND SUBQ TISSUE1011611NANA4377Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED1012251NANA4378Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION1012251NANA4379Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21705DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB101331NANA4380Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23405TENOTOMY SHOULDER AREA 1 TENDON101331NANA4381Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT40819EXC FRENUM LABIAL/BUCCAL101981NANA4382Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT41115EXCISION LINGUAL FRENUM FRENECTOMY101981NANA4383Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT52601TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE101461NANA4384Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61783STEREOTACTIC COMPUTER ASSISTED PX SPINAL1012251NANA4385Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64713NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS101331NANA4386Carrier G2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric1101NANA4387Carrier G2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric1101NANA4388Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG340.529499.334NANA4389Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M330.545599.833NANA4390Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV and MN240.5417102.224NANA4391Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION120.66679842.3111NANA4392Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES110.454572.54338NANA4393Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT80307DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE80.3754092.717NANA4394Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY W/PATIENT W/E and M SRVCS 30 MIN60.83331226NANA4395Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96131PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR60.8333686NANA4396Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM60.833332.360.733NANA4397Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR50.882.85NANA4398Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR21185.52NANA4399Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96121NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR21188.52NANA4400Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR21185.52NANA4401Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR21185.52NANA4402Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0018BHVAL HEALTH; SHORT-TERM RES W/O ROOM and BOARD-DIEM2172.52NANA4403Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT80305DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE114011NANA4404Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90838PSYCHOTHERAPY W/PATIENT W/E and M SRVCS 60 MIN113501NANA4405Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE111NANA4406Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015ALCOHL and /RX SRVC;INTENSV OP;CRISIS INTRVN and ACTV TX11491NANA4407Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2012BEHAVIORAL HEALTH DAY TREATMENT PER HOUR11351NANA4408Carrier G2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES1100.0972.656.138NANA4409Carrier G2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN1617345.9115NANA4410Carrier G2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOW FOR TX CGM1 MO SPL Equal to 1 U OF SERVICE1101NANA4411Carrier G2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT USE WITH NONDME INTRSTL CGM101NANA4412Carrier G2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN1617345.9115NANA4413Carrier G2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0553SUPPLY ALLOW FOR TX CGM1 MO SPL Equal to 1 U OF SERVICE1101NANA4414Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1390O2 CONC 1 DEL PORT 85 PCT OR GT 02 CONC AT PRSC FLW RATE780.628225.8114.5870NANA4415Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS120.2568.212NANA4416Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS100155.610NANA4417Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1960AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB90.6667439NANA4418Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE80.12538.38NANA4419Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0466HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF80.519.880.344NANA4420Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS8157.38NANA4421Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS80.25133.68NANA4422Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0108OTHER ACCESSORIES70.57141147NANA4423Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2628FABRICATION AND FITTING OF OCULAR CONFORMER70.857155.97NANA4424Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571LAPS TOTAL HYSTERECT 250 GM OR LT W/RMVL TUBE/OVARY1101NANA4425Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA1175.61NANA4426Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTB9998NOC FOR ENTERAL SUPPLIES11481NANA4427Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0240BATH/SHOWER CHAIR W/WO WHEELS ANY SIZE1132.11NANA4428Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0656SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK1193.51NANA4429Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0986MNL WHEELCHAIR ACSS PUSH-RIM ACT PWR ASSIST SYS111NANA4430Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1020RESIDUAL LIMB SUPPORT SYSTEM WHEELCHAIR ANY TYPE11961NANA4431Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1161MANUAL ADULT SIZE WHEELCHAIR INCLUDES TILT SPACE11150.11NANA4432Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1815DYN ADJ ANKLE EXT/FLEX DEVC INCL SOFT INTF MATL1199.21NANA4433Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2325PWR WC ACSS SIP AND PUFF INTERFCE NONPROPRTNAL11681NANA4434Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL2999LOWER EXTREMITY ORTHOSES NOT OTHERWISE SPECIFIED101811NANA4435Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4157ENTRAL F NUTRITION CMPL INHERITED DZ METAB200.5194811NANA4436Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4649SURGICAL SUPPLY; MISCELLANEOUS400.25329531NANA4437Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM500.253.55NANA4438Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV500.2133.85NANA4439Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0766ELEC STIM DVC U CANCER TX INCL ALL ACC ANY TYPE500.21599214NANA4440Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2623PROSTHETIC EYE PLASTIC CUSTOM500.273.25NANA4441Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2628FABRICATION AND FITTING OF OCULAR CONFORMER700.142955.97NANA4442Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0466HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF800.12519.880.344NANA4443Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS800.12557.38NANA4444Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)490.881.78365569973.67917831544NANA4445Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)460.852.82628865970.91364191442NANA4446Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump3600.1295270676.0658810221323NANA4447Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)290.831.14728072256.84775353722NANA4448Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar280.961.95092027877.24536074127NANA4449Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)2700.5512567221.804173671423NANA4450Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)230.912.10708660662.80834108221NANA4451Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)230.830.34780464386.78757963320NANA4452Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9100Cytarabine Hcl 100 Mg Inj2200.0370333331.0147785071012NANA4453Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar220.911.3848452558.50804957418NANA4454Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis2206.04509143522NANA4455Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft14186.0474187414NANA4456Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22843Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)8112.3035455119.8537760326NANA4457Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)511.65684560828.2805745732NANA4458Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63012Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)4166.069012264NANA4459Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63052Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root during posterior interbody arthrodesis, single segment41102.65148834NANA4460Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22325Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar4110.547317584NANA4461Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47135Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age4127.2522222230.3824363913NANA4462Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63046Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic310.35368376519.4554952821NANA4463Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63053Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root, during posterior interbody arthrodesis, each additional segment31103.11508323NANA4464Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61867Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array3137.562407413NANA4465Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63056Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)3151.614188833NANA4466Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical31152.06048883NANA4467Carrier J2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach3117.237517323NANA4468Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical30.33152.06048883NANA4469Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar280.071.95092027877.24536074127NANA4470Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20931Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)150.070.13277777847.76105976114NANA4471Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)460.072.82628865970.91364191442NANA4472Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar210.052.10708660675.47881978219NANA4473Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar220.051.3848452558.50804957418NANA4474Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)230.042.10708660662.80834108221NANA4475Carrier J2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)490.041.78365569973.67917831544NANA4476Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility54480.71.96735763123.238813862826.61002415543318NANA4477Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes51580.75.3288260924.466141531535.85453711514711NANA4478Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes46530.71.70930319524.26427263871.85104214463911NANA4479Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities41860.690.70692594523.990699222004.755235441829NANA4480Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete29610.944.2546396982764.829615NANA4481Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis28510.940.4345833334.213635609122839NANA4482Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr25970.880.2173611115.4166985081622.934375425933NANA4483Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine18350.8833.277222225.8060296073096218333NANA4484Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation17430.966.8772222222.8207357361608417392NANA4485Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences15730.960.1297222223.4454402121473.848889215714NANA4486Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)3315.8774831024.548783045627NANA4487Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29898Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive2710.0377777782.3362931653043241NANA4488Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75557Cardiac MRI for morph2516.34854444425NANA4489Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77435Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions20111.4252833343.97194503317NANA4490Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72142Contrast MRI of cervical spine2010.01845833320NANA4491Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37243Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction20110.2006508317.92338387218NANA4492Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77373Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions19112.4130772246.59385613316NANA4493Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72149Contrast MRI of lumbar spine1813.79422839518NANA4494Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75635CTA abdm arta/lg artry w/o & w/cntrs1610.01300347216NANA4495Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72147Contrast MRI of thoracic spine1610.01277777816NANA4496Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15832Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh116351.9111671NANA4497Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15879Suction assisted lipectomy; lower extremity116351.9111671NANA4498Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15839Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area116351.9111671NANA4499Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15877Suction assisted lipectomy; trunk116351.9111671NANA4500Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22849Reinsertion of spinal fixation device20.584.80557252NANA4501Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63655Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural20.572.497581952NANA4502Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22852Removal of posterior segmental instrumentation30.3377.097565913NANA4503Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29805Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)50.25.458238057163.636878514NANA4504Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63045Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical110.1857.2516621211NANA4505Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29862Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum70.1451.253686657NANA4506Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder2560.9813.4346571329.23745095494432531NANA4507Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric550.832.1522222242.348606775365.357623522NANA4508Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric191536.30154625.84960406217NANA4509Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification2112.06753056487221NANA4510Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99221Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.200.087308752NANA4511Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT14302Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)10238.92186581NANA4512Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT95714Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored100.0872047231NANA4513Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete10238.92186581NANA4514Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret100.0871611121NANA4515Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9217Leuprolide Acetate Suspnsion100.0857352771NANA4516Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services100.0058333341NANA4517Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra10238.92186581NANA4518Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT14301Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm10238.92186581NANA4519Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach10238.92186581NANA4520Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99223Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.100.0875000021NANA4521Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0018Alcohol And/Or Drug Services100.08719639851.213NANA4522Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99222Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.100.0875000021NANA4523Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric191536.30154625.84960406217NANA4524Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification2112.06753056487221NANA4525Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder2560.9813.4346571329.23745095494432531NANA4526Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric550.832.1522222242.348606775365.357623522NANA4527Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.200.087308752NANA4528Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT14302Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)10238.92186581NANA4529Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95714Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored100.0872047231NANA4530Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete10238.92186581NANA4531Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95720Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret100.0871611121NANA4532Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9217Leuprolide Acetate Suspnsion100.0857352771NANA4533Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services100.0058333341NANA4534Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra10238.92186581NANA4535Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT14301Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm10238.92186581NANA4536Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54520Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach10238.92186581NANA4537Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99223Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.100.0875000021NANA4538Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0018Alcohol And/Or Drug Services100.08719639851.213NANA4539Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99222Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.100.0875000021NANA4540Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual2380.611.16689083349.71417048208812371NANA4541Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)2320.932.809104673232NANA4542Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services204113.4194950914.005359173201NANA4543Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours1150.9140.940329115NANA4544Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session1040.9328.8476640636.9558035434805991NANA4545Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management1040.9335.4324786837.279013754100NANA4546Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem910.9718.2841666726.99379394190NANA4547Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management780.9538.7977493535.17500741375NANA4548Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes530.637.9968515853NANA4549Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain440.982.59833333344NANA4550Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92522Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);8118.127668788NANA4551Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81229Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities719.8271286972071NANA4552Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450CT, head or brain wo contrast410.0315277784NANA4553Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction4142.58276164NANA4554Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT41899Unlisted procedure, dentoalveolar structures3143.046680553NANA4555Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81416Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)3132.246909263NANA4556Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92609Therapeutic services for the use of speech-generating device, including programming and modification3128.349682393NANA4557Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81415Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis3132.246909263NANA4558Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21122Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)21150.15662922NANA4559Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes2154.460040282NANA4560Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)212949.9051312NANA4561Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21296Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach21173.16598332NANA4562Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81243FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles2112.3662572021NANA4563Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]36450.961.854224334144036452NANA4564Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)18710.342040998187NANA4565Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate1020.9920.492777780.210775487221001NANA4566Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos260.2719.5073055644.5256387125NANA4567Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi260.2782.6006443726NANA4568Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine150.2142.587637215NANA4569Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable150.333.796158334117.8163427114NANA4570Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq1300.2164899313NANA4571Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor110.0996.5561868711NANA4572Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate1000.62238478410NANA4573Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)18710.342040998187NANA4574Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861PWC gp 3 std mult pow opt s/b3123.048903433NANA4575Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0856PWC gp 3 std sing pow opt s/b111NANA4576Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate1020.9920.492777780.210775487221001NANA4577Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]36450.961.854224334144036452NANA4578Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal50.686.140786675NANA4579Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified20.510.07501572NANA4580Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable150.333.796158334117.8163427114NANA4581Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos260.2719.5073055644.5256387125NANA4582Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi260.2782.6006443726NANA4583Carrier J2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Elec Osteogen Stim Spinal50.286.140786675NANA4584Carrier J2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]364501.854224334144036452NANA4585Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin840.9627.22983188624841NANA4586Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system700.8005138497NANA4587Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc7011.985676397NANA4588Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply600.9196027326NANA4589Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl6013.350627616NANA4590Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml500.0698048335NANA4591Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4253Blood Glucose/Reagent Strips105.1609555551NANA4592Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.0059000021NANA4593Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin840.9627.22983188624841NANA4594Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system700.8005138497NANA4595Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc7011.985676397NANA4596Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply600.9196027326NANA4597Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl6013.350627616NANA4598Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml500.0698048335NANA4599Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4253Blood Glucose/Reagent Strips105.1609555551NANA4600Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.0059000021NANA4601Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6730.7778.854170503ADALIMUMABNA4602Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4100.69510.846.334376CYCLOSPORINE (OPHTH)NA4603Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3530.01110.747.5154199INSULIN GLARGINENA4604Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2980.0741451.665233TIRZEPATIDENA4605Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2950.5199.8134.8129166OXYCODONE HCLNA4606Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2800.68922.492.884196GALCANEZUMAB-GNLMNA4607Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2770.53415.4127.690187HYDROCODONE-ACETAMINOPHENNA4608Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2660.33128.363.851215DUPILUMABNA4609Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2450.0048.148.444201SEMAGLUTIDENA4610Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2390.778.434.148191ETANERCEPTNA4611Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA711.734.725TAFLUPROSTNA4612Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA618.260OSIMERTINIB MESYLATENA4613Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5112.327.441DABRAFENIB MESYLATENA4614Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5114.628.914TERIPARATIDE (RECOMBINANT)NA4615Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511.869.441IBRUTINIBNA4616Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3110.82.921ANAKINRANA4617Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2120.620NINTEDANIB ESYLATENA4618Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2127.720REGORAFENIBNA4619Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2148.402ABALOPARATIDENA4620Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1150.901DEUCRAVACITINIBNA4621Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3122.524.511ALPELISIBNA4622Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA7112.720TRAMETINIB DIMETHYL SULFOXIDENA4623Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA31154.102INSULIN GLULISINENA4624Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.6673.2187.811ABEMACICLIBNA4625Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA80.667157.102SARILUMABNA4626Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1820.52.910RISANKIZUMAB-RZAANA4627Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1340.51.6238.611APREMILASTNA4628Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA320.52.410PALBOCICLIBNA4629Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA160.515.910INSULIN REGULAR (HUMAN)NA4630Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA120.5150.101SOFOSBUVIR-VELPATASVIRNA4631Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)500.0848138425NANA4632Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)5120.465835625NANA4633Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9100Cytarabine Hcl 100 Mg Inj400.0606054NANA4634Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47135Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age412.433759.76639819422NANA4635Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61781Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)400.0842857224NANA4636Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99223Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.302.1102333340.04742041712NANA4637Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96415Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)302.1102333340.04750180612NANA4638Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96413Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug302.1102333340.04744958412NANA4639Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar3124.862173763NANA4640Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)3121.493932723NANA4641Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61519Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma300.0829163893NANA4642Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)5120.465835625NANA4643Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47135Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age412.433759.76639819422NANA4644Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar3124.862173763NANA4645Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)3121.493932723NANA4646Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible21121.27634032NANA4647Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)211.4150370382NANA4648Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor116.4022222231NANA4649Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27132Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft1119.004416671NANA4650Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar112.1010277781NANA4651Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38205Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic116.4022222231NANA4652Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44238Unlisted laparoscopy procedure, intestine (except rectum)11145.43294171NANA4653Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)111.1747222231NANA4654Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)112.1010277781NANA4655Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49654Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible1114.828402781NANA4656Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)1126.495256391NANA4657Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)1126.495256391NANA4658Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63051Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)110.0430555561NANA4659Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63052Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root during posterior interbody arthrodesis, single segment1123.815384171NANA4660Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63030Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar1126.495256391NANA4661Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical110.0430555561NANA4662Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar112.1010277781NANA4663Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)112.1010277781NANA4664Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63200Laminectomy, with release of tethered spinal cord, lumbar1123.003018611NANA4665Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2110.0430555561NANA4666Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis1860.913.457180484721861NANA4667Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete1850.935.466368528185NANA4668Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr1680.7411.37845238168NANA4669Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1350.936.37458534620161351NANA4670Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation1220.94.890858175122NANA4671Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1150.798.11394349524001151NANA4672Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250DIAGNOSTIC CT THORAX W/O CNTRST850.913.86500308785NANA4673Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI, any joint of upper extremity; wo co780.7611.3461077678NANA4674Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain660.857.23077294766NANA4675Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93307ECHO, transthoracic, heart, complete640.9710.2014603264NANA4676Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260DIAGNOSTIC CT THORAX W/CONTRAST640.951.65082491664NANA4677Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70491Contrast CAT scan of neck tissue1917.88334795319NANA4678Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74177CT abd & pelv w contrast1710.02807098817NANA4679Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70544MRA, head, w/o contrast1215.51993589712NANA4680Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1112.2833838382016111NANA4681Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr8115.972777788NANA4682Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73223MRI upr ext jnt w/o cntrst flwd cnt7114.353492067NANA4683Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77301Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications717.4702599332.8047406952NANA4684Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29827Arthroscopy, shoulder, surgical; with rotator cuff repair718.094536684252071NANA4685Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74181MRI, abdomen; wo contrast material(s)7111.346354177NANA4686Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64491Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure)714.0214600397NANA4687Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29823Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si7114.40305817NANA4688Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77338Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan717.4702599332.8047406952NANA4689Carrier I2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93350Stress ECHO exam of heart250.0417.448525NANA4690Carrier I2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77049MRI breast bilateral C-/+ w/CAD390.0310.8236805639NANA4691Carrier I2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73221MRI, any joint of upper extremity; wo co780.0111.3461077678NANA4692Carrier I2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70553MRI of brain and further sequences1350.016.37458534620161351NANA4693Carrier I2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73721MRI, lower extremity any joint; wo contr1680.0111.37845238168NANA4694Carrier I2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder18131.5564857618NANA4695Carrier I2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric5163.935833335NANA4696Carrier I2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric311.97194444512.6339226412NANA4697Carrier I2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder18131.5564857618NANA4698Carrier I2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric5163.935833335NANA4699Carrier I2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric311.97194444512.6339226412NANA4700Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12183.1343867112NANA4701Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem11126.9778469411NANA4702Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction6118.368542736NANA4703Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete6118.368542136NANA4704Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management5125.5847222212.4467822214NANA4705Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session5125.5847222212.4467822214NANA4706Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management5125.5847222212.4467810414NANA4707Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours50.836.597357945NANA4708Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences410.0002083334NANA4709Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)210.0002777762NANA4710Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue20.545.863537922NANA4711Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318Breast reduction21123.18426192NANA4712Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12183.1343867112NANA4713Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem11126.9778469411NANA4714Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction6118.368542736NANA4715Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete6118.368542136NANA4716Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management5125.5847222212.4467822214NANA4717Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session5125.5847222212.4467822214NANA4718Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management5125.5847222212.4467810414NANA4719Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences410.0002083334NANA4720Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71271Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)210.0002777762NANA4721Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction21123.18426192NANA4722Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]2810.951.995146947281NANA4723Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)190.896.46160818719NANA4724Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos50.481.358090175NANA4725Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate410.0001388894NANA4726Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0960Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware3023.187570653NANA4727Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq3021.676033333NANA4728Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each3023.187530283NANA4729Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi3040.8443305661.4739236112NANA4730Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in2032.472398612NANA4731Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in200.0442634722NANA4732Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B2034.778370832NANA4733Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware2032.472452782NANA4734Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate410.0001388894NANA4735Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor11133.95138891NANA4736Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]2810.951.995146947281NANA4737Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)190.896.46160818719NANA4738Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos50.481.358090175NANA4739Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0960Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware3023.187570653NANA4740Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq3021.676033333NANA4741Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each3023.187530283NANA4742Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi3040.8443305661.4739236112NANA4743Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in2032.472398612NANA4744Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in200.0442634722NANA4745Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B2034.778370832NANA4746Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware2032.472452782NANA4747Carrier I2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin120.580.61408055526.50367164111NANA4748Carrier I2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin120.580.61408055526.50367164111NANA4749Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA390.8462.160.7930ADALIMUMABNA4750Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2603.813.6521RIMEGEPANT SULFATENA4751Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA250.82128124CYCLOSPORINE (OPHTH)NA4752Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA210.8575.836.1516ETANERCEPTNA4753Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA200.2521.245.2911RIFAXIMINNA4754Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA200.66.2554.9317RISANKIZUMAB-RZAANA4755Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA180.27821.636.2414DUPILUMABNA4756Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA180.523.9142711HYDROCODONE-ACETAMINOPHENNA4757Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA170.70645.252.5116GALCANEZUMAB-GNLMNA4758Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1601.112.3115UBROGEPANTNA4759Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8140.108LIFITEGRASTNA4760Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6113.506GUSELKUMABNA4761Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA319.725.821MORPHINE SULFATENA4762Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA315603LEVALBUTEROL TARTRATENA4763Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3141.103ELEXACAFTOR-TEZACAFTOR-IVACAFTORNA4764Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA212.266.611HYDROCODONE BITARTRATENA4765Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA21613.902TERIPARATIDE (RECOMBINANT)NA4766Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2123.302ALIROCUMABNA4767Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1164.601TUCATINIBNA4768Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1145.201FENTANYLNA4769Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3119.510TOCILIZUMABNA4770Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1144.210IVABRADINE HCLNA4771Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.52.210ABEMACICLIBNA4772Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA170.252.210GALCANEZUMAB-GNLMNA4773Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA180.224.301HYDROCODONE-ACETAMINOPHENNA4774Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA200.1329.701RIFAXIMINNA4775Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)70.712.79134805470.3900182216NANA4776Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)70.862.791348054111.048635916NANA4777Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar60.832.79134805477.4588196215NANA4778Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar512.791348054117.043052214NANA4779Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)512.79134805478.137382914NANA4780Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT55866Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed4018.412370424NANA4781Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44620Closure of enterostomy, large or small intestine;400.08691250.761622NANA4782Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22802Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments30.6769.376399173NANA4783Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS2068Breast DIEP flag reconstruct300.0865222220.78575138812NANA4784Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11971Removal of tissue expander without insertion of implant300.08661750.78851208212NANA4785Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)30.67139.35759473NANA4786Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49000Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)300.0801277780.76477777812NANA4787Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)30.6749.17061653NANA4788Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49568Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)300.0865611120.7857986112NANA4789Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar512.791348054117.043052214NANA4790Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)512.79134805478.137382914NANA4791Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20931Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)212.791348054289.312018611NANA4792Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27486Revision of total knee arthroplasty, with or without allograft; 1 component11115.27178141NANA4793Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component11115.27178141NANA4794Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37215Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection110.6949999991NANA4795Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63030Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar1193.066944441NANA4796Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)1197.462759171NANA4797Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar11289.31201861NANA4798Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63001Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical11103.87294811NANA4799Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical110.1380555551NANA4800Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)11289.31201861NANA4801Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion1197.462759171NANA4802Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47370Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency110.0151NANA4803Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22843Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)11101.65521751NANA4804Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49565Repair recurrent incisional or ventral hernia; reducible1118.589444441NANA4805Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63051Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)110.1380555551NANA4806Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility3760.716.86832128403762NANA4807Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes3710.7116.560136269603711NANA4808Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes2750.6719.318187527202751NANA4809Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2630.97.54533625745362631NANA4810Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities2360.6319.745511187202361NANA4811Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr2350.8920.662222225.89100226896012341NANA4812Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis2170.920.0727777786.737107843163212161NANA4813Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1510.848.820283224151NANA4814Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1360.954.436449716136NANA4815Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation1350.974.253513072135NANA4816Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72156MRI of cervical spine2811.57593518528NANA4817Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1710.03767973917NANA4818Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng1612.66786458416NANA4819Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29823Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si15157.9162269415NANA4820Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81162BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements)11118.94451811NANA4821Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77338Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan1110.9854166667.28447666729NANA4822Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77301Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications1010.9852777787.87430694528NANA4823Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70480CT, orbit, sella or pos fos wo contrast1011.97855555510NANA4824Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70498CTA, neck, w/o cntrst flwd by cntrst1013.70741666710NANA4825Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr1016.89338888910NANA4826Carrier A2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8614Cochlear implant system11674.53638891NANA4827Carrier A2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT69930Cochlear device implantation, with or without mastoidectomy11674.53638891NANA4828Carrier A2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73721MRI, lower extremity any joint; wo contr2350.0120.662222225.89100226896012341NANA4829Carrier A2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine1510.018.820283224151NANA4830Carrier A2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder3131.808425933NANA4831Carrier A2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services1011.980461111NANA4832Carrier A2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA4833Carrier A2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder3131.808425933NANA4834Carrier A2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services1011.980461111NANA4835Carrier A2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA4836Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)320.884.85801215332NANA4837Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual150.630.6546724415NANA4838Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services80.8820.658610289.89624960317NANA4839Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain40.7512.011458334NANA4840Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management40.542.9002777856.5798099113NANA4841Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session40.542.9002777856.579902513NANA4842Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management30.6742.9002777823.6173537512NANA4843Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours3144.394537043NANA4844Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834Psychotherapy, 45 minutes with patient2025.087069032NANA4845Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes2144.204902782NANA4846Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem2114.2341666714.6894444411NANA4847Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853Group psychotherapy (other than of a multiple-family group)2025.087069032NANA4848Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90847Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes2025.087069032NANA4849Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97113Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises2144.204902782NANA4850Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours3144.394537043NANA4851Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes2144.204902782NANA4852Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem2114.2341666714.6894444411NANA4853Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97113Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises2144.204902782NANA4854Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131Physical therapy, in the home, per diem110.4429305551NANA4855Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450CT, head or brain wo contrast1101NANA4856Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71271Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)320.884.85801215332NANA4857Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services80.8820.658610289.89624960317NANA4858Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain40.7512.011458334NANA4859Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management30.6742.9002777823.6173537512NANA4860Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]2450.942.69965873245NANA4861Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)1410.04162698414NANA4862Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate80.883.3449305558NANA4863Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable50.468.24032855NANA4864Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal40.540.27916254NANA4865Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi30130.25263893NANA4866Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos3052.960211673NANA4867Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine3048.992962963NANA4868Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor30129.17666673NANA4869Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate202.3620908342NANA4870Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi202.3620908342NANA4871Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension202.3620908342NANA4872Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B202.3623686112NANA4873Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0637Combination sit to stand system, any size, with seat lift feature, with or without wheels203.2692073622NANA4874Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each202.3623686112NANA4875Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware202.3622297232NANA4876Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)1410.04162698414NANA4877Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]2450.942.69965873245NANA4878Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate80.883.3449305558NANA4879Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal40.540.27916254NANA4880Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable50.468.24032855NANA4881Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi30130.25263893NANA4882Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos3052.960211673NANA4883Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine3048.992962963NANA4884Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor30129.17666673NANA4885Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate202.3620908342NANA4886Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi202.3620908342NANA4887Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension202.3620908342NANA4888Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B202.3623686112NANA4889Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0637Combination sit to stand system, any size, with seat lift feature, with or without wheels203.2692073622NANA4890Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each202.3623686112NANA4891Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware202.3622297232NANA4892Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin10114.0148223110NANA4893Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl301.1945206483NANA4894Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc301.1945308343NANA4895Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system200.0863305572NANA4896Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply200.0863652782NANA4897Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin10114.0148223110NANA4898Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl301.1945206483NANA4899Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc301.1945308343NANA4900Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system200.0863305572NANA4901Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply200.0863652782NANA4902Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA680.85312.639.2860ADALIMUMABNA4903Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA500.682533.6347CYCLOSPORINE (OPHTH)NA4904Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA470.8519.226.62027INSULIN GLARGINENA4905Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA310.5819.954.2526HYDROCODONE-ACETAMINOPHENNA4906Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA270.7045.7136.11512OXYCODONE W/ ACETAMINOPHENNA4907Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA250.3210.598.4322EVOLOCUMABNA4908Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA25022.748.4124TIRZEPATIDENA4909Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.7513.263.2420GALCANEZUMAB-GNLMNA4910Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.7081.434.4420ETANERCEPTNA4911Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA220.27338.822.9616DUPILUMABNA4912Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA412.923.613FENTANYLNA4913Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3115.957.712LIFITEGRASTNA4914Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA312.430ACALABRUTINIB MALEATENA4915Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2186.602MAVACAMTENNA4916Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA211.920CANNABIDIOLNA4917Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2117.319.711CANAGLIFLOZIN-METFORMIN HCLNA4918Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2131.802INSULIN ASPART (WITH NIACINAMIDE)NA4919Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2116.14511ABALOPARATIDENA4920Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA21309.402ELAGOLIX SODIUMNA4921Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2156.702TERIPARATIDE (RECOMBINANT)NA4922Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11222.910SELEXIPAGNA4923Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA115.310GLYCOPYRRONIUM TOSYLATENA4924Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1123.910ANAKINRANA4925Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA240.66783.802GALCANEZUMAB-GNLMNA4926Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA130.5234.601ERENUMAB-AOOENA4927Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA500.167141.801CYCLOSPORINE (OPHTH)NA4928Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA250.15425.1312.611EVOLOCUMABNA4929Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95716Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance50.2151.705NANA4930Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap�4149.204NANA4931Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT55866Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed4169.604NANA4932Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)4176.604NANA4933Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG)40189.504NANA4934Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38571Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy3192.603NANA4935Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58571Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)31379.803NANA4936Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15860Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�2114.202NANA4937Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21743Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), with thoracoscopy20131.202NANA4938Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32666Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral2122.7143.511NANA4939Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33361Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach20.567.3134.211NANA4940Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33362Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach20.583.111NANA4941Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38570Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple21490.302NANA4942Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38900Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)21490.302NANA4943Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)�21102.102NANA4944Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49568mplantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)2195.602NANA4945Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap�4149.204NANA4946Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed4169.604NANA4947Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)4176.604NANA4948Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy3192.603NANA4949Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)31379.803NANA4950Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15860Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�2114.202NANA4951Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32666Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral2122.7143.511NANA4952Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38570Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple21490.302NANA4953Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38900Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)21490.302NANA4954Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)�21102.102NANA4955Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49568mplantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)2195.602NANA4956Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple2650.8426.435.82263NANA4957Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)2640.8232.437.23261NANA4958Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique�2190.8452.539.81218NANA4959Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45384Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps1290.8219.32129NANA4960Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)9110.12.8190NANA4961Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple9010.12.2387NANA4962Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure870.9120.287NANA4963Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist580.556258NANA4964Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk530.752.526.6152NANA4965Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist430.515543NANA4966Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)9110.12.8190NANA4967Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple9010.12.2387NANA4968Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)2610.11.9125NANA4969Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43248Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire2511.825NANA4970Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52356Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)�2310.20.11013NANA4971Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT87799Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism2210.222NANA4972Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D and C2119.32.9219NANA4973Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52442Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)18112.818NANA4974Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81256HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D)1619.116NANA4975Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43251Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique1410.214NANA4976Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52332Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)1410.20.2311NANA4977Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT87798Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism1410.214NANA4978Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTZ12.11Encounter for screening for malignant neoplasm of colon21228020NANA4979Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTF64.9Gender identity disorder, unspecified11240010NANA4980Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTM26.6Temporomandibular joint disorders11456010NANA4981Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTM47.816Spondylosis without myelopathy or radiculopathy, lumbar region11312010NANA4982Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTN80.01Superficial endometriosis of the uterus11336010NANA4983Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTn80.13Superficial endometriosis of bilateral ovaries11336010NANA4984Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTN93.9Abnormal uterine and vaginal bleeding, unspecified11336010NANA4985Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTR41.83Borderline intellectual functioning11696010NANA4986Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTZ91.89Other specified personal risk factors, not elsewhere classified11648010NANA4987Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis stimulator, low intensity ultrasound, non-invasive40.540.204NANA4988Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory3097.303NANA4989Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable3192.803NANA4990Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment2181.802NANA4991Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis stimulator, electrical, noninvasive, other than spinal applications2010302NANA4992Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications2113.402NANA4993Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0956Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each2197.302NANA4994Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1002Wheelchair accessory, power seating system, tilt only2185.702NANA4995Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL0482TLSO, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated�2157.802NANA4996Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8691Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each219502NANA4997Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable3192.803NANA4998Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment2181.802NANA4999Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications2113.402NANA5000Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL0482TLSO, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated�2157.802NANA5001Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8691Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each219502NANA5002Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair accessory, positioning belt/safety belt/pelvic strap, each114901NANA5003Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1802Dynamic adjustable forearm pronation/supination device, includes soft interface material�110.101NANA5004Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1805Dynamic adjustable wrist extension / flexion device, includes soft interface material�110.101NANA5005Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access117.401NANA5006Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005Ultralightweight wheelchair�114901NANA5007Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA714.0611.04430STELARA INJ 90MG/MLNA5008Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA511.4211.04320ENBREL SRCLK INJ 50MG/MLNA5009Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.810.91040TALTZ INJ 80MG/MLNA5010Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA90.443.4710.32130DUPIXENT INJ 300/2MLNA5011Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.81.319.51130NURTEC TAB 75MG ODTNA5012Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA317.25030AIMOVIG INJ 140MG/MLNA5013Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA212.6111.15110AJOVY INJ 225/1.5NA5014Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA219.9020OZEMPIC INJ 4MG/3MLNA5015Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA219.4020ENTRESTO TAB 24-26MGNA5016Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA216.87020DUPIXENT INJ 200MGNA5017Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin8159.808NANA5018Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service40.525.937.113NANA5019Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system�30.3325.943.812NANA5020Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories212371.711NANA5021Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply20.5109.902NANA5022Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor212371.711NANA5023Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)1195.801NANA5024Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278Receiver (monitor); external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)1195.801NANA5025Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin8159.808NANA5026Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories212371.711NANA5027Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor212371.711NANA5028Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)1195.801NANA5029Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278Receiver (monitor); external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)1195.801NANA5030Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service40.525.937.113NANA5031Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply20.5109.902NANA5032Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system�30.3325.943.812NANA5033Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE10.65Dexcom - - TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS40.51.518.6111NANA5034Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE10.65FreeStyle- TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS40.251.5910NANA5035Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);50.80.358.414NANA5036Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap3143.953NANA5037Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15860Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�21422NANA5038Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38562Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic20.590.12NANA5039Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38900Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)�20.590.12NANA5040Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49255Omentectomy, epiploectomy, resection of omentum (separate procedure)20.590.12NANA5041Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap3143.953NANA5042Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15860Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�21422NANA5043Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15770Graft; derma-fat-fascia1145.91NANA5044Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21615Excision first and/or cervical rib11124.21NANA5045Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21705Division of scalenus anticus; with resection of cervical rib11124.21NANA5046Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31622Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)118.41NANA5047Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32100Thoracotomy; with exploration118.41NANA5048Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32607Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral118.41NANA5049Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38530Biopsy or excision of lymph node(s); open, internal mammary node(s)1145.91NANA5050Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT39200Resection of mediastinal cyst118.41NANA5051Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45400Laparoscopy, surgical; proctopexy (for prolapse)11981NANA5052Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57250Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy11981NANA5053Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57288Sling operation for stress incontinence (eg, fascia or synthetic)�11981NANA5054Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57425Laparoscopy, surgical, colpopexy (suspension of vaginal apex)�11981NANA5055Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)11981NANA5056Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58700Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)�1198.41NANA5057Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95714Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored�1190.71NANA5058Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95720Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG)1190.71NANA5059Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96365Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour�1148.11NANA5060Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96366Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)�1148.11NANA5061Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.1190.71NANA5062Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTC1771Repair device, urinary, incontinence, with sling graft11981NANA5063Carrier K2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTQ67.6Pectus excavatum111248010NANA5064Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)1300.8149.422.75125NANA5065Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1200.8249.419.95115NANA5066Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique1110.8149.420.74107NANA5067Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45384Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps580.7624.958NANA5068Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure530.9212.953NANA5069Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)350.910.210.4134NANA5070Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple350.910.28.4134NANA5071Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist350.7142.5114.6134NANA5072Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk270.724.532.3334NANA5073Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist240.67145.924NANA5074Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499Chiropractic Care2370.996237NANA5075Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499Therapy Care3890.982389NANA5076Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81162BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements)15113.4015NANA5077Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43248�Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire1310.211.3112NANA5078Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81420Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 2112110.3012NANA5079Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52332Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)1010.158.928NANA5080Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81256HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D)�1010.35010NANA5081Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)912.309NANA5082Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64490Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level�910.1409NANA5083Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43251Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique810.20.1417NANA5084Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)�8127.962.117NANA5085Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52353Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)710.20.1316NANA5086Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81401MOLECULAR PATHOLOGY PROCEDURE LEVEL 2710.1107NANA5087Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81519Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as recurrence score712.8707NANA5088Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499Chiropractic Care2370.996237NANA5089Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499Therapy Care3890.982389NANA5090Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTF64.9Gender identity disorder, unspecified10.5264020NANA5091Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG47.30Sleep apnea, unspecified11336010NANA5092Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTI47.1Supraventricular tachycardia11360010NANA5093Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTM26.02Maxillary hypoplasia11336010NANA5094Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTM47.812Spondylosis without myelopathy or radiculopathy, cervical region11240010NANA5095Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTR07.9Chest pain, unspecified112448010NANA5096Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTZ12.11Encounter for screening for malignant neoplasm of colon11336010NANA5097Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0766Electrical stimulation device used for cancer treatment, includes all accessories, any type410.681.913NANA5098Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous3070.93NANA5099Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8614Cochlear device, includes all internal and external components20165.12NANA5100Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4087Gastrostomy/jejunostomy tube, standard, any material, any type, each11167.51NANA5101Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4088Gastrostomy/jejunostomy tube, low-profile, any material, any type, each11167.51NANA5102Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4149Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit11167.51NANA5103Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4153Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, May include fiber, administered through an enteral feeding tube, 100 calories = 1 unit11167.51NANA5104Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0642Standing frame/table system, mobile (dynamic stander), any size including pediatric1170.91NANA5105Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1805Dynamic adjustable wrist extension / flexion device, includes soft interface material110.21NANA5106Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL2330Addition to lower extremity, lacer molded to Patient model, for custom fabricated orthosis only114.11NANA5107Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8615Headset/headpiece for Use with cochlear implant device, replacement1125.11NANA5108Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8616Microphone for Use with cochlear implant device, replacement1125.11NANA5109Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8619Cochlear implant, external speech processor and controller, integrated system, replacement1125.11NANA5110Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8624Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each1125.11NANA5111Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4087Gastrostomy/jejunostomy tube, standard, any material, any type, each11167.51NANA5112Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4088Gastrostomy/jejunostomy tube, low-profile, any material, any type, each11167.51NANA5113Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4149Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit11167.51NANA5114Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4153Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, May include fiber, administered through an enteral feeding tube, 100 calories = 1 unit11167.51NANA5115Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0642Standing frame/table system, mobile (dynamic stander), any size including pediatric1170.91NANA5116Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766Electrical stimulation device used for cancer treatment, includes all accessories, any type410.681.913NANA5117Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1805Dynamic adjustable wrist extension / flexion device, includes soft interface material110.21NANA5118Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2330Addition to lower extremity, lacer molded to Patient model, for custom fabricated orthosis only114.11NANA5119Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8615Headset/headpiece for Use with cochlear implant device, replacement1125.11NANA5120Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8616Microphone for Use with cochlear implant device, replacement1125.11NANA5121Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear implant, external speech processor and controller, integrated system, replacement1125.11NANA5122Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8624Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each1125.11NANA5123Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin40.552.44NANA5124Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories1139.91NANA5125Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1139.91NANA5126Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service1045.21NANA5127Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system1045.21NANA5128Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories1139.91NANA5129Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1139.91NANA5130Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin40.552.44NANA5131Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service1045.21NANA5132Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system1045.21NANA5133Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE10.65Dexcom - - TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS60.8310.2205NANA5134Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE10.66FreeStyle - - TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS2113.5702NANA5135Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA130.922.449.481110DUPIXENT INJ 300/2MLNA5136Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA110.912.111.49730STELARA INJ 90MG/MLNA5137Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA911.910.5360EMGALITY INJ 120MG/MLNA5138Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA819.1080XIFAXAN TAB 550MGNA5139Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA100.62.439.9240SKYRIZI PEN INJ 150MG/MLNA5140Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA511.6412.5230ENBREL SRCLK INJ 50MG/MLNA5141Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA70.578.54040TALTZ INJ 80MG/MLNA5142Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA413.1810.75310AIMOVIG INJ 140MG/MLNA5143Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA50.82.5711.52130HUMIRA INJ 40/0.4MLNA5144Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA60.511.76030UBRELVY TAB 100MGNA5145Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST10117.84466667010NANA5146Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED80.25143.223506908NANA5147Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY7118.9730952407NANA5148Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY7192.3947222211.4947222216NANA5149Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45330SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS5124.0957222205NANA5150Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG50.863.41777778123.353055614NANA5151Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720ELECTROENCEPHALOGRAM (EEG), CONTINUOUS RECORDING, PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL REVIEW OF RECORDED EVENTS, ANALYSIS OF SPIKE AND SEIZURE DETECTION, EACH INCREMENT OF GREATER TH50.625.8894444405NANA5152Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS417.77916666704NANA5153Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT40.2555.8480555604NANA5154Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION40.588.1431944404NANA5155Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST10117.84466667010NANA5156Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY7192.3947222211.4947222216NANA5157Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY7118.9730952407NANA5158Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45330SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS5124.0957222205NANA5159Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58140MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR4121.9934027804NANA5160Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614ARTHRD PST TQ 1NTRSPC EA ADD41122.229930604NANA5161Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS417.77916666704NANA5162Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0185INJ., APREPITANT, 1 MG31150.800370403NANA5163Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405RPLCMT PROST AORTIC VALVE XCP HOMOGRF/STENT311.11194444413.4048611112NANA5164Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT316.4897222222.68930555612NANA5165Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED80.25143.223506908NANA5166Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG50.863.41777778123.353055614NANA5167Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION40.588.1431944404NANA5168Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT40.2555.8480555604NANA5169Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633ARTHRD CMBN 1NTRSPC LUMBAR40.2563.3955555677.2976851913NANA5170Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION30.3333114.556851903NANA5171Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM20.570.2577777852.6113888911NANA5172Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20931ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL1025.3463888901NANA5173Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22802ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG10161.641944401NANA5174Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22843POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG10161.675277801NANA5175Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585Botox2120.8963316196NANA5176Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCQ5103Inflectra1110.9529473279NANA5177Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCO621431.38857013161NANA5178Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ3380Entyvio570.9816591146NANA5179Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ7323Euflexxa520.850.360151NANA5180Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0178Eylea500.922754842NANA5181Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9217Lupron Depot/eligard470.8316451136NANA5182Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30520SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF400.852.8568125040NANA5183Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSTD EMBRYO HATCHING MICROTQS ANY METH400.55140.8267361040NANA5184Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS390.666731.19041311039NANA5185Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCO621431.38857013161NANA5186Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2350Ocrevus2911642722NANA5187Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C19119.11361111135.8474074118NANA5188Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN19137.16324561019NANA5189Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2777Vabysmo161629214NANA5190Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000CYSTOURETHROSCOPY (SEPARATE PROCEDURE)12172.62516204012NANA5191Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21196RECONSTRUCTION OF MANDIBULAR RAMUS, SAGITTAL SPLIT; IN INTERNAL RIGID FIXATION11157.66227273011NANA5192Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99354PROLNG SVC O/P 1ST HOUR10133.8973611153.605937528NANA5193Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66982EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIR10114.24536111010NANA5194Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9299Opdivo101242246NANA5195Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89253ASSTD EMBRYO HATCHING MICROTQS ANY METH400.55140.8267361040NANA5196Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS390.666731.19041311039NANA5197Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT380.789558.55517544038NANA5198Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89258CRYOPRSRV EMBRYO270.6296131.0831276027NANA5199Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89342STORAGE, (PER YEAR); EMBRYO(S)230.6522106.5142633023NANA5200Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS4011IVF PACKAGE220.5105.7116667022NANA5201Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31267NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS210.47621.89527777864.18061111120NANA5202Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31276NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION200.559.72013888992.69424383218NANA5203Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31255NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY TOTAL90.444497.5266666709NANA5204Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER70.571453.7523015907NANA5205Carrier M2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY250.9226.8391666712.8031746421NANA5206Carrier M2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY9111.3697222214.95245NANA5207Carrier M2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADETOXIFICATION110.09361111101NANA5208Carrier M2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY9111.3697222214.95245NANA5209Carrier M2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADETOXIFICATION110.09361111101NANA5210Carrier M2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY250.9226.8391666712.8031746421NANA5211Carrier M2023Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY250.9226.8391666712.8031746421NANA5212Carrier M2023Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY9111.3697222214.95245NANA5213Carrier M2023Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANADETOXIFICATION110.09361111101NANA5214Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT501839.5197833050NANA5215Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN450.9556130.0407222045NANA5216Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN420.9286158.0830952042NANA5217Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN420.9524155.3306085042NANA5218Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN390.9744163.1087892039NANA5219Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H3319.80180555665.04741936231NANA5220Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH2036A/D TX PROGRAM, PER DIEM210.952481.1856944428.45656433219NANA5221Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG130.6923312.391047013NANA5222Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY, 45 MINUTES WITH PATIENT1211.03583333322.5030303111NANA5223Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M120.6667331.9065972012NANA5224Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT501839.5197833050NANA5225Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H3319.80180555665.04741936231NANA5226Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY, 45 MINUTES WITH PATIENT1211.03583333322.5030303111NANA5227Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION91103.969475309NANA5228Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES5110.9131111105NANA5229Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT311645.73907403NANA5230Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99215OFFICE O/P EST HI 40-54 MIN3184.9692592603NANA5231Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES A MEDICALLY APPROPRIATE HISTORY AND/OR EXAMINATION AND MODERATE LEVEL OF MEDICAL DECISION MAKING. WHEN USING TIME FOR CODE SELECTION, 30-39 MINUT31431.151296303NANA5232Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90846FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT212292.117502NANA5233Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)2146.7334722202NANA5234Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN450.9556130.0407222045NANA5235Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN420.9524155.3306085042NANA5236Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN420.9286158.0830952042NANA5237Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG130.6923312.391047013NANA5238Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M120.6667331.9065972012NANA5239Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90832PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES5110.9131111105NANA5240Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90836PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN40.7529.3797222204NANA5241Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR1021.647501NANA5242Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99205OFFICE O/P NEW HI 60-74 MIN10115.611944401NANA5243Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97158GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN10119.219444401NANA5244Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0486ORAL DEVICE/APPLIANCE CUSFAB2059.6704166702NANA5245Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5845KNEE-SHIN SYS STANCE FLEXION1128.2630555601NANA5246Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.1977777801NANA5247Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5968MULTIAXIAL ANKLE W DORSIFLEX1121.8994444401NANA5248Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5652SUCTION SUSP AK/KNEE DISART1128.2511111101NANA5249Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan 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authorization requests during the previous plan yearCPTL5652SUCTION SUSP AK/KNEE DISART1128.2511111101NANA5256Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.1977777801NANA5257Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5968MULTIAXIAL ANKLE W DORSIFLEX1121.8994444401NANA5258Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8460SHRINKER ABOVE KNEE1128.2388888901NANA5259Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5649ISCH CONTAINMT/NARROW M-L SO1128.2122222201NANA5260Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5650TOT CONTACT AK/KNEE DISART S1128.1827777801NANA5261Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5651AK FLEX INNER SOCKET EXT FRA1128.2047222201NANA5262Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5999LOWR EXTREMITY PROSTHES NOS1128.0880555601NANA5263Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5631AK/KNEE DISARTIC ACRYLIC SOC1128.2766666701NANA5264Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0486ORAL DEVICE/APPLIANCE CUSFAB2159.6704166702NANA5265Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5845KNEE-SHIN SYS STANCE FLEXION1128.2630555601NANA5266Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.1977777801NANA5267Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5968MULTIAXIAL ANKLE W DORSIFLEX1121.8994444401NANA5268Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5652SUCTION SUSP AK/KNEE DISART1128.2511111101NANA5269Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5649ISCH CONTAINMT/NARROW M-L SO1128.2122222201NANA5270Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5650TOT CONTACT AK/KNEE DISART S1128.1827777801NANA5271Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5631AK/KNEE DISARTIC ACRYLIC SOC1128.2766666701NANA5272Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5999LOWR EXTREMITY PROSTHES NOS1128.0880555601NANA5273Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5828ENDO KNEE-SHIN FLUID SWG/STA1128.257501NANA5274Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7970.5226.47758901214.7008832501796180SEMAGLUTIDERYBELSUS,OZEMPIC5275Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3510.72651.4725440387.2798934690802710TESTOSTERONEANDROGEL5276Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3030.82186.56642205610.367177080672360SEMAGLUTIDEWEGOVY5277Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2940.391213.8661646613.648846430742200TIRZEPATIDEMOUNJARO5278Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2380.89921.4800177311.48573750471910OMEPRAZOLEOMEPRAZOLE5279Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2270.581514.3548755819.519862990901370AMPHET/DEXTRADDERALL,MYDAYIS5280Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1890.73542.53364734312.014646610231660TACROLIMUSPROTOPIC5281Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1780.67428.01510802536.257706510341440DUPILUMABDUPIXENT5282Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1560.76285.2420643949.8552967710431130DULAGLUTIDETRULICITY5283Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1430.88810.7642695479.4549050930271160PANTOPRAZOLEPANTOPRAZOLE5284Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3610.16.7504320CLASCOTERONEWINLEVI5285Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1710.114.6666666701160LANSOPRAZOLELANSOPRAZOLE5286Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1410.11802120RABEPRAZOLERABEPRAZOLE,PANTOPRAZOLE,OMEPRAZOLE5287Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1313615.2727272702110IMMUNE GLOBULINHIZENTRA5288Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1210.10.101110PLECANATIDETRULANCE5289Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA11114.4120560DIROXIMEL FUMARATEVUMERITY5290Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1110.114.401100TAZAROTENE TOPICALARAZLO5291Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010.13780640MORPHINE SULMORPHINE5292Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA916280450BUPROPION/DEXTROMETHORPHANAUVELITY5293Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81360800VALGANCICLOVIRVALGANCICLOVIR5294Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA91480.10270SEMIGLUTIDEWEGOVY5295Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA41240.10130SEMIGLUTIDERYBELSUS,OZEMPIC5296Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA41120160130LIRAGLUTIDESAXENDA5297Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA410.1400130USTEKINUMABSTELARA5298Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.1240120TESTOSTERONETESTOSTERONE,DEPO-TESTOSTERONE5299Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.1360120METHYLPHENIDATECONCERTA,JORNAY,QUILLIVANT,RELEXXII5300Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.10.10210MODAFINILMODAFINIL5301Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3116030FREMANEZUMAB-VFRMAJOVY5302Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3132030DUPILUMABDUPIXENT5303Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2124020TIRZEPATIDEMOUNJARO,TIRZEPATIDE5304Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)80.62514.4940.71171NANA5305Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)60.833314.4930.415NANA5306Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)50.837.1351NANA5307Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar50.849.3251NANA5308Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar40.7514.4937.6813NANA5309Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533Coronary artery bypass, using arterial graft(s); single arterial graft400.012.1613NANA5310Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar40.7540.8841NANA5311Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)30.666757.7997232NANA5312Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)3181.6597232NANA5313Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22585Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)20.559.8721NANA5314Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47563Laparoscopy, surgical; cholecystectomy with cholangiography201.262NANA5315Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44205Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy205.020.0111NANA5316Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33508Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure)200.092NANA5317Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22845Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)20.558.672NANA5318Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33518Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure)200.092NANA5319Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)20.556.332NANA5320Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44213Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)201.240.0911NANA5321Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)3181.6597232NANA5322Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)11107.8976811NANA5323Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134Revision of total hip arthroplasty; both components, with or without autograft or allograft1120.751NANA5324Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33340Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation111.631NANA5325Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach1163.61NANA5326Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion11107.891NANA5327Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63042Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar112.5476811NANA5328Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)116.941NANA5329Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64999Unlisted procedure, nervous system116.941NANA5330Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22600Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment1153.631NANA5331Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49593Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible1191.061NANA5332Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility4250.6820.69425NANA5333Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes3800.678921.57380NANA5334Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple3590.96664.6614.27103491NANA5335Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)3360.95544.6619.3240103261NANA5336Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes3270.648322.03327NANA5337Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete3080.91235.65308NANA5338Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities2560.652319.94256NANA5339Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr2310.88316.61231NANA5340Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique2200.97737.4914.8927662142NANA5341Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT abd & pelv w contrast1670.95210.284.831166NANA5342Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)33134.3633NANA5343Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng2610.69120261NANA5344Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70552Contrast MRI of brain201020NANA5345Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45384Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps19111.2319NANA5346Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl1810.0118NANA5347Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1611.4716NANA5348Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29823Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si16142.16161NANA5349Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45381Colonoscopy, flexible; with directed submucosal injection(s), any substance1410.0218.05113NANA5350Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78816Imaging PET/CT full body1317.6913NANA5351Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr1118.9511NANA5352Carrier A2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72196MRI, pelvis; with contrast material(s)60.16670.6614.7315NANA5353Carrier A2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine1630.012316.27163NANA5354Carrier A2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT71250DIAGNOSTIC CT THORAX W/O CNTRST950.01050.278.181681941NANA5355Carrier A2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73721MRI, lower extremity any joint; wo contr2310.00436.61231NANA5356Carrier A2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder7136.667NANA5357Carrier A2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder7136.667NANA5358Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-360.88893.3836NANA5359Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual200.4542.2620NANA5360Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services20117.3620NANA5361Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management80.7534.72136.7326NANA5362Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session80.7534.72136.7326NANA5363Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management80.7534.72136.7326NANA5364Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem60.833354.386NANA5365Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours5138.045NANA5366Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT92523Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)2119.392NANA5367Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain210.072NANA5368Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834Psychotherapy, 45 minutes with patient204.152NANA5369Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services20117.3620NANA5370Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours5138.045NANA5371Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92523Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)2119.392NANA5372Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain210.072NANA5373Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67900Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)11114.661NANA5374Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1101NANA5375Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21209Osteoplasty, facial bones; reduction11114.661NANA5376Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21137Reduction forehead; contouring only11114.661NANA5377Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21270Malar augmentation, prosthetic material11114.661NANA5378Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility1119.141NANA5379Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete1122.641NANA5380Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97140Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes1119.141NANA5381Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2035Alcohol and/or other drug treatment program, per hour1172.131NANA5382Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30400Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip11114.661NANA5383Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction1122.641NANA5384Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]3000.952.13300NANA5385Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)140.92864.0514NANA5386Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)70.85716.577NANA5387Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal20.512.992NANA5388Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable1146.441NANA5389Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable1146.441NANA5390Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]3000.952.13300NANA5391Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)140.92864.0514NANA5392Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)70.85716.577NANA5393Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal20.512.992NANA5394Carrier A2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]3000.00332.13300NANA5395Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin50.612.015NANA5396Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml404.540.0131NANA5397Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc1020.261NANA5398Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4217Sterile water/saline, 500 ml100.011NANA5399Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl1020.261NANA5400Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin50.612.015NANA5401Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml404.540.0131NANA5402Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc1020.261NANA5403Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4217Sterile water/saline, 500 ml100.011NANA5404Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl1020.261NANA5405Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA520.634628.1946.092725HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN5406Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA520.30777.432844SEMAGLUTIDEOZEMPIC, RYBELSUS5407Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA500.8234.5852.451139ADALIMUMABHUMIRA5408Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA460.195718.6941.79442TIRZEPATIDEMOUNJARO5409Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA320.8751.6828.39131CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, RESTASIS5410Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.833310.6779.91618DUPILUMABDUPIXENT, DUPIXENT DUPILUMAB5411Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2406.310.21321SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY5412Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA220.63646.7342.8913OXYCODONE HCLOXYCODONE HCL, OXYCONTIN5413Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA160.756.09192.26511GALCANEZUMAB-GNLMEMGALITY5414Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA160.81252.4940.85214ETANERCEPTENBREL5415Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12118.0162.8348FREMANEZUMAB-VFRMAJOVY5416Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1218.3127.1439PLECANATIDETRULANCE5417Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9137.5741.5918RISANKIZUMAB-RZAASKYRIZI5418Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA715.181.761OXYCODONE W/ ACETAMINOPHENOXYCODONE-ACETAMINOPHEN5419Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6133.9306TOCILIZUMABACTEMRA5420Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5113.0424.6641BUPRENORPHINEBUPRENORPHINE5421Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511.436.5214DULAGLUTIDETRULICITY5422Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4114.7340.7413UPADACITINIBRINVOQ/ER5423Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4110.140BUPRENORPHINE HCLBELBUCA5424Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA311.9837.8312LIFITEGRASTXIIDRA5425Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA217.7320HYDROCODONE BITARTRATEHYDROCODONE BITARTRATE5426Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11309.7601SIPONIMOD FUMARATEMAYZENT5427Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11265.8601NICOTINENICOTROL5428Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11234.6201ERENUMAB-AOOEAIMOVIG5429Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.425.0597.1811EVOLOCUMABREPATHA SURECLICK5430Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially 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yearCPTJ0585INJECTION,ONABOTULINUMTOXINA300.767342108.904260NANA5457Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM210.9052485.201200NANA5458Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE170.82424011401160NANA5459Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ7323EUFLEXXA INJ PER DOSE150.8672454.901140NANA5460Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA140.92910210320860NANA5461Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN130.769079.400130NANA5462Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479UNLISTED MOLECULAR PATHOLOGY120.83304600120NANA5463Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION810330080NANA5464Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION70.8570240070NANA5465Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY380.974010.100380NANA5466Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA230.767552117.801220NANA5467Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM190.9052462.701180NANA5468Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE140.8240113.100140NANA5469Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ7323EUFLEXXA INJ PER DOSE130.867243801120NANA5470Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA130.929113.110320760NANA5471Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81479UNLISTED MOLECULAR PATHOLOGY100.83303600100NANA5472Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN100.769074.400100NANA5473Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION810330080NANA5474Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9276DISPOSABLE SENSOR, CGM SYS7148440160NANA5475Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633Arthrodesis214800200NANA5476Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ0585INJECTION, ONABOTULINUMTOXINA, 1 UNIT; Other complications of pregnancy212400200NANA5477Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30465Under Repair Procedures on the Nose112400100NANA5478Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36476�Endovascular Ablation Therapy of Incompetent Extremity Veins�1104320010NANA5479Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27279ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE (INDIRECT VISUALIZATION), WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, AND PLACEMENT OF TRANSFIXING DEVICE1108400010NANA5480Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31599Endoscopic laryngoplasty, Percutaneous laryngeal injections, and Removal of a keel or stent.1101440010NANA5481Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73221Magnetic resonance imaging (MRI) of the upper extremity without contrast material1109840010NANA5482Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL2055Hip-knee-ankle-foot Orthotics11024480010NANA5483Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT42975drug-induced sleep endoscopy (DISE) that includes a dynamic evaluation of the tongue base, velum, pharynx, and larynx to assess sleep-disordered breathing.11030960010NANA5484Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTQ5103INFLECTRA1102640010NANA5485Carrier N2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124MENTAL HEALTH INPATIENT3100300NANA5486Carrier N2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002SUBSTANCE ABUSE RESIDENTIAL2100200NANA5487Carrier N2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001MENTAL HEALTH RESIDENTIAL1000100NANA5488Carrier N2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124MENTAL HEALTH INPATIENT3100300NANA5489Carrier N2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002SUBSTANCE ABUSE RESIDENTIAL2100200NANA5490Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION (TMS)4100040NANA5491Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM2100020NANA5492Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION2100020NANA5493Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853MENTAL HEALTH GROUP THERAPY1100010NANA5494Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035EATING DISORDER PARTIAL HOSPITALIZATION PROGRAM1100010NANA5495Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT036TAPPLIED BEHAVIORAL ANALYSIS1100010NANA5496Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION (TMS)4100040NANA5497Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM2100020NANA5498Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION2100020NANA5499Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853MENTAL HEALTH GROUP THERAPY1100010NANA5500Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035EATING DISORDER PARTIAL HOSPITALIZATION PROGRAM1100010NANA5501Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT036TAPPLIED BEHAVIORAL ANALYSIS1100010NANA5502Carrier N2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151ABA Therapy1102640010NANA5503Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5645BK FLEX INNER SOCKET EXT FRA1101440010NANA5504Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5301BK MOLD SOCKET SACH FT ENDO1101440010NANA5505Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5679SOCKET INSERT W/O LOCK MECH1101440010NANA5506Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5629BELOW KNEE ACRYLIC SOCKET1101440010NANA5507Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8699PROSTHETIC IMPLANT NOS10000010NANA5508Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5637BELOW KNEE TOTAL CONTACT1101440010NANA5509Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5940ENDO BK ULTRA-LIGHT MATERIAL1101440010NANA5510Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH110960010NANA5511Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5685BELOW KNEE SUS/SEAL SLEEVE1101440010NANA5512Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5620TEST SOCKET BELOW KNEE1101440010NANA5513Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5645BK FLEX INNER SOCKET EXT FRA1101440010NANA5514Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5301BK MOLD SOCKET SACH FT ENDO1101440010NANA5515Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5679SOCKET INSERT W/O LOCK MECH1101440010NANA5516Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5629BELOW KNEE ACRYLIC SOCKET1101440010NANA5517Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5637BELOW KNEE TOTAL CONTACT1101440010NANA5518Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5940ENDO BK ULTRA-LIGHT MATERIAL1101440010NANA5519Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH110960010NANA5520Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5685BELOW KNEE SUS/SEAL SLEEVE1101440010NANA5521Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5620TEST SOCKET BELOW KNEE1101440010NANA5522Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0861PWC GP3 STD MULT POW OPT S/B110960010NANA5523Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA790.371.3828.5309700SemaglutideOZEMPIC5524Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA630.84131.0338.58016470RimegepantNURTEC5525Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA450.82.3440.82508370SsemaglutideWEGOVY5526Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA430.470.26252.87507360SsemaglutideOZEMPIC5527Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA380.928.0729.725010280SsemaglutideOZEMPIC5528Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.5610.98552.64015210LisdexamfetamineVYVANSE5529Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.891.3420.695015210DeucravacitinibSTELARA5530Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA340.560.9633.9206280RuxolitinibOPZELURA5531Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA330.391.4419.2502310TirzepatideMOUNJARO5532Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA310.2957.62560.77016150EmtricitabineTenofovir Alafenamide)DESCOVY5533Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA271116.6406210AdalimumabHUMIRA5534Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2410.0123.501680ApixabanELIQUIS5535Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1610.010.0202140DupilumabDUPIXENT5536Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1511.0513.720690Amphetamine and DextroamphetamineDEXTROAMPHETAMINE5537Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA13111.5117.0702110EvolocumabREPATHA SURECLICK5538Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1310.0134.530490Risankizumab-rzaaSKYRIZI PEN5539Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010.010.010550ConcertaMETHYLPHENIDATE ER5540Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1016.700100SsemaglutideWEGOVY5541Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA918.860.040720MenotropinsMENOPUR5542Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA911.62470360Erenumab-aooeAIMOVIG5543Carrier N2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA313200300UstekinumabSTELARA5544Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853METALLIC MESH BETWEEN VERTEBRAE130.92310189.8800130NANA5545Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT MATERIAL ATTACHED TO SPINE100.7054.0200100NANA5546Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK101061.2200100NANA5547Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842SPINAL INSTRUMENTATION PLACE AT BACK OF SPINE TO CORRECT DEFORMITY91040.120090NANA5548Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614SPINAL FUSION TO JOIN TWO VERTEBRAE91049.390090NANA5549Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048ADDITIONAL VERTEBRAE SEGMENT DURING ANOTHER PROCEDURE90.8889056.060090NANA5550Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION910245.010090NANA5551Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22845SPINAL INSTRUMENTATION PLACE AT FRONT OF SPINE TO CORRECT DEFORMITY90.44440244.270090NANA5552Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047INCISION AT A SINGLE VERTEBREA TO CORRECT SPINAL STENOSIS80.8750270.730080NANA5553Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT TO BONE DURING SPINAL SURGERY71055.360070NANA5554Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22848SPINAL DEVICE FIXATION TO PELVIC BONES11011.930010NANA5555Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63046SINGLE THORACIC VERTEBRAL TO CORRECT STENOSIS21094.060020NANA5556Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487REVISION OF KNEE JOINT WITH FEMORAL AND TIBIAL COMPONENTS11077.870010NANA5557Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE11164.8300100NANA5558Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840PLACEMENT OF SPINAL INSTRUMENTATION IN THE NECK ACROSS C1-C2.710317.790070NANA5559Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20939AUTOGRAFT TO BONE DURING SPINAL SURGERY21022.280020NANA5560Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734MUSCLE FLAP FROM AN AREA OF THE TRUNK110.8900100NANA5561Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20939BONE MARROW HARVEST TO USE AS A BONE GRAFT21022.280020NANA5562Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045SINGLE CERVICAL VERTEBRAL PROCEDURE21033.390020NANA5563Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551CERVICAL DISC REMOVAL FROM FRONT OF NECK TO RELIEVE PAIN11050.880010NANA5564Carrier B2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT44204LAPAROSCOPIC PARTIAL REMOVAL OF COLON1100.120010NANA5565Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD1410.7305083.31001410NANA5566Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE1110.7027072.27001110NANA5567Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN970.532147.77131.120.0710861NANA5568Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-14580.5347078.5800580NANA5569Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-7560.5053077.2300560NANA5570Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0483DEFINITIVE DRUG TEST OF CLASSES 22+560.0215078.5100560NANA5571Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION,ONABOTULINUMTOXINA930.817211.634.1707860NANA5572Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0482DEFINITIVE DRUG TEST OF CLASSES 15-22550.022078.9200550NANA5573Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0299DIRECT SKILLED NURSING SERVICES OF A REGISTERED NURSE IN HOME OR HOSPICE SETTING6510116.500650NANA5574Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ3489ZOLEDRONIC ACID 1MG (ZOMETA)830.915728.6719.4703800NANA5575Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72110X-RAY OF AT LEAST 4 VIEWS OF THE LUMBOSACRAL SPINE01000000NANA5576Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9607LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN THER 1 MCI (PLUVICTO)114.1900100NANA5577Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG6002STEREOSCOPIC X-RAY GUIDANCE TO ASSIST WITH RADIATION THERAPY TARGETING1124.5800100NANA5578Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9145INJECTION DARATUMUMAB 10 MG (DARZALEX)-CHEMOTHERAPY11044.580010NANA5579Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31575LARYNGOSCOPY FLEXIBLE FIBEROPTIC TO LOOK INSIDE THE LARYNX01000000NANA5580Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81379GENETIC TEST TO FOR HIGH RESOLUTION OF HUMAN LEUKOCYTE ANTIGEN GENES310209.250030NANA5581Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9304INJECTION PEMETREXED PEMFEXY 10 MG FOR CHEMOTHERAPY1100.030010NANA5582Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81380GENETIC TEST TO FOR HIGH RESOLUTION OF HUMAN LEUKOCYTE ANTIGEN GENES, FOR CLASS 1, USING MOLECULAR TECHNIQUES210228.850020NANA5583Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue650ROUTINE HOME HOSPICE CARE DELIVERED IN A NURSING FACILITY01000000NANA5584Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81383GENETIC TEST TO FOR HIGH RESOLUTION OF HUMAN LEUKOCYTE ANTIGEN GENES, FOR CLASS 2 ALLELE GROUP210228.850020NANA5585Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT1480ANESTHESIA SERVICES FOR OPEN PROCEDURE OF THE LOWER LEG, ANKLE, AND FOOT01000000NANA5586Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95024ALLERGY SKIN TESTING01000000NANA5587Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99385WELL-PATIENT VISIT FOR PATIENT 18-39 YEARS OLD.01000000NANA5588Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH0031MENTAL HEALTH ASSESSMENT BY A NON-PHYSICIAN01000000NANA5589Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30435SURGURY TO REPAIR OR CHANGE SHAPE OF THE NOSE ON A PATIENT WHO HAS HAD THE SURGERY BEFORE11075.470010NANA5590Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCH2015COMPREHENSIVE COMMUNITY SUPPORT SERVICES, PER 15 MINUTES01000000NANA5591Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27829SURGIICAL REPAIR INJURY TO THE TIBIOFIBULAR JOINT AND SECURES THE TIBIA AND FIBULA WITH PLATES AND SCREWS, WIRES OR PINS01000000NANA5592Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90677PNEUMONIA VACCINE FOR INTRAMUSCULAR USE01000000NANA5593Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99125RISK OR PHYISICAL STATUS FOR ANESTHESIA01000000NANA5594Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80050LAB TEST FOR A GENERAL HEALTH PANEL01000000NANA5595Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY1130.9187022.18001130NANA5596Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY670.9851014.1700670NANA5597Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED34107.8300340NANA5598Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue100ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY31011.210030NANA5599Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC11030.670010NANA5600Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED34107.8300340NANA5601Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC11030.670010NANA5602Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue100ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY31011.210030NANA5603Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY670.9851014.1700670NANA5604Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY1130.9187022.18001130NANA5605Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM481045.7200480NANA5606Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES291040.6500290NANA5607Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY131038.2800130NANA5608Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT101048.9600100NANA5609Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS910106.910090NANA5610Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHOLOGICAL DIAGNOSTIC EVALUATION110189.80010NANA5611Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM21000020NANA5612Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVALUATION BY A PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL UP TO 1 HOUR.21061.370020NANA5613Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES2100.120020NANA5614Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR21023.190020NANA5615Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS910106.910090NANA5616Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES2100.120020NANA5617Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC EVALUATION IN ADDITION TO RENDERING ADDITIONAL MEDICAL SERVICES01000000NANA5618Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY131038.2800130NANA5619Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT VISIT TO AN ESTABLISHED PATIENT11000010NANA5620Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHOLOGICAL DIAGNOSTIC EVALUATION110189.80010NANA5621Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVALUATION BY A PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL UP TO 1 HOUR.21061.370020NANA5622Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION USED TO IMPROVE DEPRESSION11023.620010NANA5623Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAVIOR TREATMENT FACE TO FACE TO MODIFY TARGETS AND TREATMENT TECHNIQUES, 15 MINUTES2100.120020NANA5624Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869TRANSCRANIAL MAGNETIC STIMULATION SUBSQUENT REDETERMINATION11024.620010NANA5625Carrier B2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY130.0714038.2800130NANA5626Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE5490.92754.6175.54055440NANA5627Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR1000.830428.0281.7708920NANA5628Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH590.915339.9276.8201580NANA5629Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS410.891312.156.8802390NANA5630Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP320.878817.8570.7601310NANA5631Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE160.523.6597.5202140NANA5632Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP101070.300100NANA5633Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399DURABLE MEDICAL EQUIPMENT NOT CLASSIFIED ELSEWHERE110.818232.1171.4501100NANA5634Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP91061.050090NANA5635Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENTILATOR, USED WITH NON-INVASIVE INTERFACE (MASK, CHEST SHELL)80.750116.740080NANA5636Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2313POWER WHEELCHAIR HARNESS11044.760010NANA5637Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8690AUDITORY OSSEOINTEGRATED DEVICE INCLUDES ALL INTERNAL & EXTERNAL COMPONENTS31073.940030NANA5638Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005ULTRALIGHTWEIGHT WHEELCHAIR210113.670020NANA5639Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM11000010NANA5640Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0188SYNTHETIC SHEEPSKIN PAD110140.540010NANA5641Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0261HOSPITAL BED SEMI-ELECTRIC WITH ANY RAILS AND WITHOUT MATTRESS210193.260020NANA5642Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP101070.300100NANA5643Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0277POWERED PRESS-REDUCING AIR MATRESS1132.1100100NANA5644Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861POWER WH EELCHAIR, GROUP 3 , STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, UP TO 300LBS IN WEIGHT11044.760010NANA5645Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0303HEAVY DUTY HOSPITAL BED, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 350 POUNDS BUT LESS THAN OR EQUAL TO 600 POINS, WITH ANY TYPE SIDE RAILS AND MATTRESS417.7567.660130NANA5646Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1161MANUAL ADLUT SIZE WHEELCHAIR INCLUIDING TILT SPACE20.5070.060020NANA5647Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0108OTHER ACCESSORY NOT LISTED40.25081.180040NANA5648Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0001STANDARD WHEELCHAIR50.2057.770050NANA5649Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0630PATIENT LIFT HYDRAULIC50.250.3970.570140NANA5650Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0562HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE70.125082.960070NANA5651Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0935PASSIVE MOTION EXERCISE DEVICE160.12523.6597.5202140NANA5652Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399DURABLE MEDICAL EQUIPMENT NOT CLASSIFIED ELSEWHERE110.090932.1171.4501100NANA5653Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1390PORTABLE OXYGEN CONCENTRATOR1000.044628.0281.7708920NANA5654Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE5490.019654.6175.54055440NANA5655Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4239CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH590.016939.9276.8201580NANA5656Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY390.97513.7971.4902370NANA5657Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN141063.3800140NANA5658Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING71064.280070NANA5659Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM210100.740020NANA5660Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN141063.3800140NANA5661Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING71064.280070NANA5662Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM210100.740020NANA5663Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY390.97513.7971.4902370NANA5664Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA11600.627613606221939SemaglutideOzempic5665Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5310.3071994369462Clobetasol PropionateClobetasol5666Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3580.6872941787271LiraglutideVictoza5667Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3550.89011128170285DulaglutideTrulicity5668Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3450.31342963100245PregabalinPregabalin5669Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2550.917639653113142Hydrocodone-AcetaminophenHydroco/apap5670Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2330.81551723370163Lisdexamfetamine DimesylateVyvanse5671Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2020.792127107436166AdalimumabHumira Pen5672Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1830.8907755379786Oxycodone HClOxycodone5673Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1820.554919114324158Continuous Glucose System SensorFreesty Libr5674Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1615515579Sodium Zirconium CyclosilicateLokelma5675Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA111283011Oxybutynin ChlorideOxybutynin5676Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1114275638Segesterone Acetate-Ethinyl EstradiolAnnovera5677Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA101783010Fluticasone Propionate HFAFlovent Hfa5678Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA914935654Insulin AspartNovolog5679Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA811026EtonogestrelNexplanon5680Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8177071DasatinibSprycel5681Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA811035Levonorgestrel (IUD)Mirena5682Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7174907Ketoconazole (Topical)Ketoconazole5683Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7117876952Trifluridine-TipiracilLonsurf5684Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL12121.217.8210NANA5685Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES1011.0617.319NANA5686Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN5111.65NANA5687Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES5110.65NANA5688Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS3114.63NANA5689Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT3118.23NANA5690Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue762SPECIALTY SERVICES, OBSERVATION HOURS3120.63NANA5691Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue158ROOM & BOARD, WARD - REHABILITATION3116.73NANA5692Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99232SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES2102NANA5693Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71045RADIOLOGIC EXAM CHEST SINGLE VIEW218.12NANA5694Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL12121.217.8210NANA5695Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES1011.0617.319NANA5696Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN5111.65NANA5697Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES5110.65NANA5698Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS3114.63NANA5699Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT3118.23NANA5700Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762SPECIALTY SERVICES, OBSERVATION HOURS3120.63NANA5701Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue158ROOM & BOARD, WARD - REHABILITATION3116.73NANA5702Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99232SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES2102NANA5703Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71045RADIOLOGIC EXAM CHEST SINGLE VIEW218.12NANA5704Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES3000.99337.860.720280NANA5705Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS1870.96790.877.45182NANA5706Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES1400.99299.452.25135NANA5707Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN1180.898317.4219.64114NANA5708Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST11811742.84078NANA5709Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST8217.217.91666NANA5710Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD770.987106.677NANA5711Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST7211330.63537NANA5712Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST6917.522.23633NANA5713Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141MRI CERVICAL SPINE NO CONTRAST66114.416.41452NANA5714Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST11811742.84078NANA5715Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST8217.217.91666NANA5716Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST7211330.63537NANA5717Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST6917.522.23633NANA5718Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI CERVICAL SPINE NO CONTRAST66114.416.41452NANA5719Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS6311.429.2558NANA5720Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73221MRI RIGHT SHOULDER NO CONTRAST5518.420.62926NANA5721Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45385COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ52119.852NANA5722Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0151SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN4315.643NANA