1Carrier A2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin90.8925.04240NANA 2Carrier A2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu60384NANA 3Carrier A2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9279Monitoring feature/deviceNOC10432NANA 4Carrier A2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin90.8925.04NANA 5Carrier A2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu60NANA 6Carrier A2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9279Monitoring feature/deviceNOC10NANA 7Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINUOUS GLUCOSE MONITOR SYSTEM30139.0792.80.46NANA 8Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM131092.340NANA 9Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINUOUS GLUCOSE MONITOR710.9664.6390.110.46NANA 10Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINUOUS GLUCOSE MONITOR SYSTEM210.95084.420NANA 11Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN130.920114.750NANA 12Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINUOUS GLUCOSE MONITOR RECEIVER/MONITOR100193.680NANA 13Carrier B2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0553CONTINUOUS GLUCOSE MONITOR SYSTEM SUPPLIES100193.680NANA 14Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINUOUS GLUCOSE MONITOR SYSTEM30139.0792.80.46NANA 15Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM131092.340NANA 16Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINUOUS GLUCOSE MONITOR710.9664.6390.110.46NANA 17Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINUOUS GLUCOSE MONITOR SYSTEM210.95084.420NANA 18Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN130.920114.750NANA 19Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINUOUS GLUCOSE MONITOR RECEIVER/MONITOR100193.680NANA 20Carrier B2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0553CONTINUOUS GLUCOSE MONITOR SYSTEM SUPPLIES100193.680NANA 21Carrier 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 RECORDING111188.2NANA 22Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS810.375.4NANA 23Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE4490.996.7199.1NANA 24Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXT AMB INSULIN DELIVERY620.9810.5270.1NANA 25Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4456ADHESIVE REMOVER, WIPES, ANY TYPE, EACH110.917.2368.8NANA 26Carrier 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 GL290.8616.1429.4NANA 27Carrier 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=1D10410.8514.7371.7NANA 28Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0607HOME BLOOD GLUCOSE MONITOR100.87.3193.9NANA 29Carrier C2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1790.7863.9385.1NANA 30Carrier 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 ACCESSORIES210.6734.3956.6NANA 31Carrier 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 RECORDING111188.2NANA 32Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS810.375.4NANA 33Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA6460SYNTHETIC DRSG <= 16 SQ I210.1NANA 34Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH21382.5NANA 35Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4245ALCOHOL WIPES PER BOX110.2NANA 36Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA6461SYNTHETIC DRSG >16<=48 SQ110.1NANA 37Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9278RECEIVER MON; EXT INTERSTITIAL CONT GLU MON SYS111.5NANA 38Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4340INDWELLING CATH SPECIAL110.1NANA 39Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5120SKIN BARRIER, WIPE OR SWA11191.6NANA 40Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4352COUDE TIP URINARY CATH114.4NANA 41Carrier C2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0781INFUS PUMP AMBULATORY1011013NANA 42Carrier 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 PUMP17900.0263.9385.1NANA 43Carrier 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=1D104100.0114.7371.7NANA 44Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS INSULIN PUMP NON NE7416.2197.2NANA 45Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXT AMB INSULIN DELIVERY1719.8517.4NANA 46Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS7142.7594.1NANA 47Carrier 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 ACCESSORIES190.7919.92064.6NANA 48Carrier 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=1D4690.7513.1554.1NANA 49Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP860.6933.7474.1NANA 50Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4456ADHESIVE REMOVER, WIPES, ANY TYPE, EACH30.67199.1NANA 51Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ4186EPIFIX, PER SQ CM40.560.1258.8NANA 52Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4253BLOOD GLUCOSE/REAGENT STR20.51.2NANA 53Carrier D2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA6209FOAM DRSG <=16 SQ IN W/O201.2NANA 54Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS INSULIN PUMP NON NE7416.2197.2NANA 55Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXT AMB INSULIN DELIVERY1719.8517.4NANA 56Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS7142.7594.1NANA 57Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ4110PRIMATRIX PER SQ CM113.3NANA 58Carrier 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 ACCESSORIES190.7919.92064.6NANA 59Carrier 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=1D4690.7513.1554.1NANA 60Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP860.6933.7474.1NANA 61Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4456ADHESIVE REMOVER, WIPES, ANY TYPE, EACH30.67199.1NANA 62Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ4186EPIFIX, PER SQ CM40.560.1258.8NANA 63Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4253BLOOD GLUCOSE/REAGENT STR20.51.2NANA 64Carrier D2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0781EXTERNAL AMBULATORY INFUS200.526.21429.8NANA 65Carrier 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=1D46900.0113.1554.10NANA 66Carrier 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 PUMP8600.0133.7474.10NANA 67Carrier 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 SERVICE49118.8NANA 68Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL4813.422.6NANA 69Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC28116.4NANA 70Carrier 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=1D415.2NANA 71Carrier 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 DRESS3111.2NANA 72Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1320.933.9NANA 73Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN220.8641.1NANA 74Carrier 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 sensor320.38NANA 75Carrier E2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH30.3365NANA 76Carrier 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 SERVICE49118.8NANA 77Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL4813.422.6NANA 78Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC28116.4NANA 79Carrier 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=1D415.2NANA 80Carrier 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 DRESS3111.2NANA 81Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1320.933.9NANA 82Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN220.8641.1NANA 83Carrier 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 sensor320.38NANA 84Carrier E2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH30.3365NANA 85Carrier F2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAtest strips140.846.5745.22NANA 86Carrier F2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAtest strips140.846.5745.22NANA 87Carrier F2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAtest strips14006.5745.22NANA 88Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.899.5NANA 89Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ4186EPIFIX PER SQ CM1124NANA 90Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE100.813.231.7NANA 91Carrier 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 1D290.797.937.9NANA 92Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC90.7838.5NANA 93Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS130.7712.222NANA 94Carrier 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 SERVICE30.67NANA 95Carrier 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-5020.5NANA 96Carrier 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 INSRT1046.5NANA 97Carrier G2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499UNLISTED EVALUATION AND MANAGEMENT SERVICE1069.1NANA 98Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.895.5NANA 99Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA1156.9NANA 100Carrier 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 EA1176.5NANA 101Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ4186EPIFIX PER SQ CM1124NANA 102Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95249CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT1118.5NANA 103Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE100.814.835.4NANA 104Carrier 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 1D290.798.529.2NANA 105Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC90.7814.838.5NANA 106Carrier G2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS130.7712.222NANA 107Carrier 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 SERVICE30.671.7213.8NANA 108Carrier 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 3CC900.1114.838.5NANA 109Carrier 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 TYPE1000.114.835.4NANA 110Carrier 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 SYS1300.0812.222NANA 111Carrier 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 INSULIN1300.0814.895.5NANA 112Carrier 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 1D2900.038.529.2NANA 113Carrier H2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAtest strips2180.846.518.17NANA 114Carrier H2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAtest strips2180.846.518.17NANA 115Carrier H2020Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAtest strips218006.58.17NANA 116Carrier I2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin8120.44360NANA 117Carrier I2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin8120.440.2NANA 118Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin950.9949.14NANA 119Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu10NANA 120Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10125.98NANA 121Carrier J2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10125.98NANA 122Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin950.9949.14NANA 123Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu1011.1NANA 124Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10125.9828.7NANA 125Carrier J2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10125.98NANA 126Carrier K2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN3115.657.55NANA 127Carrier K2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN3115.657.55NANA 128Carrier 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 INSULIN30115.657.55NANA 129Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN7116.640.26NANA 130Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA3147.4NANA 131Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0607HOME BLOOD GLUCOSE MONITOR1195.5NANA 132Carrier 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=1D30.6771.31NANA 133Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS30.6771.31NANA 134Carrier L2020Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9278RECEIVER MON; EXT INTERSTITIAL CONT GLU MON SYS30.6771.31NANA 135Carrier L2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN7116.640.26NANA 136Carrier L2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA3147.4NANA 137Carrier L2020Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0607HOME BLOOD GLUCOSE MONITOR1195.5NANA 138Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5301BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM21036NANA 139Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5620S/A L5618,BELOW KNEE21036NANA 140Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5637ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT21036NANA 141Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5671ADDITION TO LOWER EXTREMITY, BELOW KNEE / ABOVE KNEE SUSPENSION LOCKING21036NANA 142Carrier 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 MECHANISM21036NANA 143Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5910ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM21036NANA 144Carrier 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 MATERIAL21036NANA 145Carrier M2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5986EQUAL) ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT ("MCP" OR21036NANA 146Carrier 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 REDUCTION20.51236NANA 147Carrier 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 HARDWARE20.51236NANA 148Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5301BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM2136NANA 149Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620S/A L5618,BELOW KNEE2136NANA 150Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT2136NANA 151Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5671ADDITION TO LOWER EXTREMITY, BELOW KNEE / ABOVE KNEE SUSPENSION LOCKING2136NANA 152Carrier 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 MECHANISM2136NANA 153Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM2136NANA 154Carrier 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 MATERIAL2136NANA 155Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5986EQUAL) ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT ("MCP" OR2136NANA 156Carrier 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.2136NANA 157Carrier M2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8420PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH2136NANA 158Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER1119.4NANA 159Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified1145.8NANA 160Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2260.952.3NANA 161Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate100.817.4496NANA 162Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate50.85.4NANA 163Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal90.5651.9NANA 164Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine20.5121.5NANA 165Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi100.2107.3NANA 166Carrier 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 wheels20112.7NANA 167Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating1081.1NANA 168Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0240Bath/shower chair, with or without wheels, any size10NANA 169Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2213Pneumatic prop tire insert1081.1NANA 170Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height1081.1NANA 171Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA 172Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware10NANA 173Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2231Solid seat support base1081.1NANA 174Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0445Oximeter Device For Measuring Blood Oxygen Levels Non-Invasively10NANA 175Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device10NANA 176Carrier 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, each1081.1NANA 177Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in1081.1NANA 178Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in10NANA 179Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0950Tray1081.1NANA 180Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE8001Upright gait trainer10NANA 181Carrier 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, each10NANA 182Carrier A2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0957Wheelchair accessory, medial thigh support, prefabricated, including fixed mounting hardware, each10NANA 183Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified1145.8NANA 184Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER1119.4NANA 185Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2260.952.3NANA 186Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate100.817.4NANA 187Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate50.85.4NANA 188Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal90.5651.9NANA 189Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine20.5121.5NANA 190Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi100.2107.3NANA 191Carrier 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 wheels20112.7NANA 192Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware10NANA 193Carrier 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, each1081.1NANA 194Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height1081.1NANA 195Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA 196Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2231Solid seat support base1081.1NANA 197Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating1081.1NANA 198Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device10NANA 199Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2213Pneumatic prop tire insert1081.1NANA 200Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in1081.1NANA 201Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0445Oximeter Device For Measuring Blood Oxygen Levels Non-Invasively10NANA 202Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0240Bath/shower chair, with or without wheels, any size10NANA 203Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in10NANA 204Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0950Tray1081.1NANA 205Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE8001Upright gait trainer10NANA 206Carrier 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, each10NANA 207Carrier A2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0957Wheelchair accessory, medial thigh support, prefabricated, including fixed mounting hardware, each10NANA 208Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT2196NANA 209Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR2124NANA 210Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1002PWR SEAT TILT1172NANA 211Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0748ELEC OSTEOGEN STIM SPINAL1148NANA 212Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0856PWC GP3 STD SING POW OPT S/B1172NANA 213Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE1148NANA 214Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0747ELEC OSTEOGEN STIM NOT SPINE1048NANA 215Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2300PWR SEAT ELEVATION SYS1072NANA 216Carrier N2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8699PROSTHETIC IMPLANT NOS1072NANA 217Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT2196NANA 218Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR2124NANA 219Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1002PWR SEAT TILT1172NANA 220Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0748ELEC OSTEOGEN STIM SPINAL1148NANA 221Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0856PWC GP3 STD SING POW OPT S/B1172NANA 222Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE1148NANA 223Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0747ELEC OSTEOGEN STIM NOT SPINE1048NANA 224Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2300PWR SEAT ELEVATION SYS1072NANA 225Carrier N2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8699PROSTHETIC IMPLANT NOS1072NANA 226Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9004PARENTERAL NUTRITION INFUSION PUMP PORTABLE1410218.620NANA 227Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM12126.1584.310NANA 228Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE5140.9528.76129.910NANA 229Carrier 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 INTERFACE200.9535.48111.490NANA 230Carrier 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 CONCENTRATION1540.9424.31191.520NANA 231Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP SINGLE OR MULTIPLE CHANNELS WORN BY PATIENT960.9354.37125.180NANA 232Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENTILATOR TYPE USED NON-INVASIVE INTERFACE140.9321.4108.130NANA 233Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE310.870165.580NANA 234Carrier 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 INTERFACE210.810129.030NANA 235Carrier B2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE100.866.32144.160NANA 236Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9004PARENTERAL NUTRITION INFUSION PUMP PORTABLE1410218.620NANA 237Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM12126.1584.310NANA 238Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0791PARENTERAL INFUSION PUMP STATIONARY SINGLE OR MULTICHANNEL710169.110NANA 239Carrier 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 EQUIPMENT51044.180NANA 240Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260HOSPITAL BED SEMI-ELECTRIC WITH ANY RAILS WITH MATTRESS510228.240NANA 241Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760OSTEOGENESIS STIMULATOR-LOW INTENSITY ULTRASOUND NON-INVASIVE410136.650NANA 242Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0483HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM, INCLUDES ALL ACCESSORIES AND SUPPLIES410211.550NANA 243Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0003LIGHTWEIGHT WHEELCHAIR4128.0678.010NANA 244Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0565COMPRESSOR AIR POWER SOURCE EQUIPMENT3129.03119.60NANA 245Carrier B2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108OTHER ACCESSORY31078.230NANA 246Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE409611.7850.04NANA 247Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE126313.2813.36NANA 248Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH4510.995.48288.240NANA 249Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT5450.988.52153.8NANA 250Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT5170.985.24105.74NANA 251Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7030CPAP FULL FACE MASK5160.980.8428.42NANA 252Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR4750.981.83125.98NANA 253Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 024620.983.84116.45NANA 254Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL12800.9314.68164.9NANA 255Carrier C2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE31860.914.53162.26NANA 256Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7031REPLACEMENT FACEMASK INTERFA416122.75816.21NANA 257Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA36516.86596.81NANA 258Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT94762NONINVASIVE EAR/PULSE OXIM O2 SAT CONT OVERNIGHT79112.3142.81NANA 259Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7032CUSHN NASAL MASK INTERFACE REPLACEMENT ONLY EACH76152.87NANA 260Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0445OXIMETER DEVICE FOR MEASURING BLOOD OXYGEN LEVELS, NON INVASIVE6413.5676.61NANA 261Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9497HIT ANTIBIOTIC Q3H DIEM5616.9491.48NANA 262Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1846KO W ADJ FLEX/EXT ROTAT MOLD5111.3484.28NANA 263Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4361OSTOMY FACE PLATE48129.17.62NANA 264Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0849TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE4711.2460.58NANA 265Carrier C2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0100CANES OF ANY MATERIAL4610.98267.66NANA 266Carrier 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, EA700.29227.380NANA 267Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5701REPLACE SOCKET AB KNEE/KNEE600.17598.09NANA 268Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2510SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH800.13759.750NANA 269Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5301BK MOLD SOCKET SACH FT ENDO1700.06733.66NANA 270Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4150ENTERAL FORMULAE CATEGORY I3900.0531.66641.68NANA 271Carrier 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 <2600.0435.97234.88NANA 272Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL1970AFO PLASTIC MOLDED W/ANKLE J4700.021.29242.97NANA 273Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA6549GRADIENT COMPRESSION STOCKING/SLEEVE NOS12200.0116.43503.16NANA 274Carrier C2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0485ORAL DEVICE/APPLIANCE PRE7300.013.95411.010NANA 275Carrier 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 PORTABLE2630029.09396.45NANA 276Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE103311.8128.7NANA 277Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603ELECTRIC BREAST PUMP45213.614.6NANA 278Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7031REPLACEMENT FACEMASK INTERFA194111.1732.6NANA 279Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND1471172.1NANA 280Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA14317.1427.1NANA 281Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 021550.994.7179.8NANA 282Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7030CPAP FULL FACE MASK1380.992.2238.2NANA 283Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER FOLDING WHEELED W/1360.9924.2423.6NANA 284Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE13180.953.8126.4NANA 285Carrier D2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604HOSP GRADE ELEC BREAST PU4350.894.9168.1NANA 286Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7031REPLACEMENT FACEMASK INTERFA194111.1732.6NANA 287Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND1471172.1NANA 288Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA14317.1427.1NANA 289Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3260POST-OP SHOE CANVAS56184.2NANA 290Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA551303.9NANA 291Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9500HIT ANTIBIOTIC Q24H DIEM4414.1115NANA 292Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW421274.6NANA 293Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205ORTHO DVC REPAIR PER 15 M3511.9232.1NANA 294Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9379HIT NOC PER DIEM3116.391.4NANA 295Carrier D2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1390OXYGEN CONCENTRATOR2516.2861.5NANA 296Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0986MAN W/C PUSH-RIM POWR SYS101256.90NANA 297Carrier 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<2200.5388.40NANA 298Carrier 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 UN1300.15486.10NANA 299Carrier 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 EA800.13528.60NANA 300Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0652PNEUMATIC COMPRESS SEGMNT W GRAD1100.09417.20NANA 301Carrier 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 TYPE1400.07551.30NANA 302Carrier 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 MINS4100.0213.4569.50NANA 303Carrier 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 PORTABLE9300.0132.81022.20NANA 304Carrier D2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0601CPAP DEVICE1318003.8126.40NANA 305Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S15411.528.8NANA 306Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR9619.312.6216NANA 307Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM2814.824.6NANA 308Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1970AFO PLASTIC MOLDED W/ANKLE J25130.8NANA 309Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR790.994.322.6NANA 310Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF580.9829.1NANA 311Carrier 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 SHOE540.9833.7NANA 312Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1310.97517.4NANA 313Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL0464TLSO 4MOD SACRO-SCAP PRE270.931.839.2NANA 314Carrier E2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION1020.8933NANA 315Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S15411.528.8NANA 316Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR9619.312.6NANA 317Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM2814.824.6NANA 318Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1970AFO PLASTIC MOLDED W/ANKLE J25130.8NANA 319Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2510.313.8NANA 320Carrier 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 PANEL24123.6NANA 321Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260HOSP BED SEMI-ELECTR W/ MATT2310.415.5NANA 322Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP1919.3NANA 323Carrier 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/LESS18127.3NANA 324Carrier E2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6212FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA16131.4NANA 325Carrier E2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399DURABLE MEDICAL EQUIPMENT MISC500.235.7NANA 326Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab5124NANA 327Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified11120NANA 328Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination1196NANA 329Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1945Afo, Molded To Patient Model, Plastic, Rigid Anterior Tibial Section1196NANA 330Carrier 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)20.536NANA 331Carrier F2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive10120NANA 332Carrier 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-shelf6189NANA 333Carrier 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 accessories5134153NANA 334Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each5134153NANA 335Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable5134153NANA 336Carrier 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 only5188NANA 337Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab5124NANA 338Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified11120NANA 339Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination1196NANA 340Carrier F2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1945Afo, Molded To Patient Model, Plastic, Rigid Anterior Tibial Section1196NANA 341Carrier 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)20.536NANA 342Carrier 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 protection400.252976NANA 343Carrier 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 supply3800.0331100NANA 344Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.898.5NANA 345Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS5144.7NANA 346Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE100.814.835.4NANA 347Carrier 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 1D290.798.529.2NANA 348Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC90.7814.838.5NANA 349Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS130.7712.222NANA 350Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0294HOSPITAL BED SEMI-ELEC W/O SIDE RAILS W/MATTRSS40.7591NANA 351Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0606AUTO EXT DEFIB W/INTGR ECG ANALY GARMENT TYPE50.698.8100.9NANA 352Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS70.4379.2NANA 353Carrier G2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE4062.6NANA 354Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN13114.895.5NANA 355Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS5144.7NANA 356Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2611GEN WC BACK CUSHN WDTH LT 22 IN HT MOUNT HARDWARE3122.477.1NANA 357Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA6550WND CARE SET NEG PRSS WND TX ELEC PUMP SPL3149.2124.7NANA 358Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7000CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH3149.2124.7NANA 359Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE3149.2124.7NANA 360Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2624SKIN PROTECT and POSITIONING WC CUSH WIDTH LT 22 IN3122.432.9NANA 361Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1960AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB3193.7NANA 362Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0295HOSP BED SEMI-ELEC W/O SIDE RAILS W/O MATTRSS2117.3326.1NANA 363Carrier G2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0108OTHER ACCESSORIES2122.44.9NANA 364Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2623PROSTHETIC EYE PLASTIC CUSTOM101140.8NANA 365Carrier 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 TYPE200.577.3NANA 366Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2628FABRICATION AND FITTING OF OCULAR CONFORMER200.572.2NANA 367Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2627SCLERAL COVER SHELL200.572.2NANA 368Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS300.335.664.7NANA 369Carrier G2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL8699PROSTHETIC IMPLANT NOT OTHERWISE SPECIFIED300.33215.4NANA 370Carrier 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 LEG300.3363NANA 371Carrier 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 PRSS700.2979.2NANA 372Carrier 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 3CC900.1114.838.5NANA 373Carrier 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 TYPE1000.114.835.4NANA 374Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab2840.993.39NANA 375Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each260.93143.35NANA 376Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair280.86102.779.2NANA 377Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified870.78102.04NANA 378Carrier 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)580.7876.54NANA 379Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr300.6466.98164.4NANA 380Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0606Aed Garment With Electrocardiogram Analysis250.6431.5460NANA 381Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive380.683.4146.3NANA 382Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications570.4386.2NANA 383Carrier H2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (non-invasive)300.3782.38NANA 384Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861Pwc Gp3 Std Mult Pow Opt S/b131159.16NANA 385Carrier 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 Depth11196NANA 386Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8614Cochlear Device/system10191.64NANA 387Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2617Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type6163NANA 388Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement6154.86NANA 389Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2609Custom Fabricated Wheelchair Seat Cushion, Any Size6166NANA 390Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1161Manual Adult Size Wheelchair, Includes Tilt In Space61111.27NANA 391Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260Hospital Bed, Seimi-electric (head And Foot Adjustment), With Any Type5185.33NANA 392Carrier H2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8694Auditory Osseointegrated Device, Transducer/actuator, Replacement Only, Each5187.43NANA 393Carrier 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, Each5179.06NANA 394Carrier 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)580176.54NANA 395Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications570186.2NANA 396Carrier 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,40178NANA 397Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications30196NANA 398Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8690Aud Osseo Dev, Int/ext Comp20152.8NANA 399Carrier 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 Pr3000.666.98NANA 400Carrier 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, (inc1100.588.7NANA 401Carrier 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, Each100.5120NANA 402Carrier H2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0606Aed Garment With Electrocardiogram Analysis2500.2931.5460NANA 403Carrier 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 Type1000.272455.79NANA 404Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate417.67432NANA 405Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi1191.24NANA 406Carrier 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, each1123.75NANA 407Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1141.07NANA 408Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2540.981.12NANA 409Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate90.899.79NANA 410Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor1024.06NANA 411Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0995Wheelchair accessory, calf rest/pad, replacement only, each10139.76NANA 412Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2361Power wheelchair accessory, 22nf sealed lead acid battery, each10139.76NANA 413Carrier I2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0484Oscillatory Positive Expiratory Pressure Device, Nonelectric, Any Type10NANA 414Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate417.672NANA 415Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi1191.2495NANA 416Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1141.077.6NANA 417Carrier 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, each1123.7516.5NANA 418Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2540.981.12NANA 419Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate90.899.79NANA 420Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0484Oscillatory Positive Expiratory Pressure Device, Nonelectric, Any Type1015.8NANA 421Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2361Power wheelchair accessory, 22nf sealed lead acid battery, each10139.7624NANA 422Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor1024.06NANA 423Carrier I2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0995Wheelchair accessory, calf rest/pad, replacement only, each10139.76NANA 424Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device35380.962.17NANA 425Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate1650.952.18NANA 426Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate660.914.21NANA 427Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal150.663.03NANA 428Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi310.5586NANA 429Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine110.3690.09NANA 430Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor120.33102.28NANA 431Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER60.3344.45NANA 432Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2615Pos back post/lat wdth <22in2024.98NANA 433Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2293Contour back for ped size wc10NANA 434Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1234Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adj, Wo Seating10NANA 435Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA 436Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneum Compres W/Cal Pressure10NANA 437Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2231Solid seat support base10NANA 438Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0667Seg Pneumatic Appl Full Leg10NANA 439Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0641Multi-position stnd fram sys10110.86NANA 440Carrier 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 wheels1073.83NANA 441Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0990Whellchair Elevating Leg Res10NANA 442Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0328Ped hospital bed, manual10NANA 443Carrier 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, each10NANA 444Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0638Standing frame system, any size, with or without wheels1047.08NANA 445Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2292Planar seat for ped size wc10NANA 446Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in10126.74NANA 447Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in10NANA 448Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device10NANA 449Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height10NANA 450Carrier J2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0950Tray10NANA 451Carrier 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, each10NANA 452Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device35380.962.17NANA 453Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate1650.952.18NANA 454Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate660.914.2115.3NANA 455Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal150.663.03NANA 456Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi310.5586NANA 457Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine110.3690.09NANA 458Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor120.33102.2828.9NANA 459Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER60.3344.456.2NANA 460Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2615Pos back post/lat wdth <22in2024.9825NANA 461Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2293Contour back for ped size wc10NANA 462Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1234Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adj, Wo Seating103.2NANA 463Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B10NANA 464Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0652Pneum Compres W/Cal Pressure1032.6NANA 465Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2231Solid seat support base1029.4NANA 466Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0667Seg Pneumatic Appl Full Leg10NANA 467Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height10NANA 468Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1028.9NANA 469Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0990Whellchair Elevating Leg Res10NANA 470Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0328Ped hospital bed, manual1029.4NANA 471Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0638Standing frame system, any size, with or without wheels1047.08NANA 472Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2613Position back cush wd <22in10126.746.1NANA 473Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2292Planar seat for ped size wc10NANA 474Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in102.4NANA 475Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0641Multi-position stnd fram sys10110.86NANA 476Carrier 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 wheels1073.83NANA 477Carrier 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, each10NANA 478Carrier 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, each10NANA 479Carrier J2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0950Tray10NANA 480Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0760Osteogen Ultrasound Stimltor1200.08102.28NANA 481Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399Durable Medical Equipment Mi3100.0386NANA 482Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601Cont Airway Pressure Device3538002.17NANA 483Carrier J2020DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0747Elec Osteogen Stim Not Spine110090.09NANA 484Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC21013.35NANA 485Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV1100.2NANA 486Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE11053.6NANA 487Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM11075.756.9NANA 488Carrier K2020DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0747OSTOGNS STIM ELEC NONINVASV OTH THAN SP APPLIC20069.2NANA 489Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC21013.35NANA 490Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV1100.2NANA 491Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE11053.6NANA 492Carrier K2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM11075.7NANA 493Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/BACK-UP3121.859.5NANA 494Carrier 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 MECH30.6762.67NANA 495Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5981ALL LOWER EXTREM PROSTH FLEX-WALK SYSTEM/EQUAL30.6752.9NANA 496Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5321ABOVE KNEE OPEN END SACH FT ENDO SYS 1 AXIS KNEE30.3362.67NANA 497Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5624ADDITION LOWER EXTREMITY TEST SOCKET ABOVE KNEE30.3362.67NANA 498Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5631ADD LW EXT ABVE KNEE/KNEE DISARTIC ACRYLC SOCKT30.3362.67NANA 499Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5649ADD LW EXT ISCHIAL CONTAINMENT/NARROW M-L SOCKET30.3362.67NANA 500Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5650ADD LW EXT TOTAL CONTACT ABVE KNEE/KNEE DISARTC30.3362.67NANA 501Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5671ADD LW EXTRM BELW/ABVE KNEE SUSP LOCK MECH30.3362.67NANA 502Carrier L2020DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5673ADD LW EXT CSTM MOLD/PRFAB FOR USE W/LOCK MECH30.3362.67NANA 503Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/BACK-UP3121.859.5NANA 504Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562HUMDIFIR HEATED USED W/POS ARWAY PRESSURE DEVICE2121.844.2NANA 505Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE2120.7NANA 506Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2820ADD LW EXT ORTH SFT INTERFCE MOLD BELW KNEE2147.25NANA 507Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620ADDITION LOWER EXTREMITY TEST SOCKET BELOW KNEE2142.25NANA 508Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637ADDITION LOWER EXTREMITY BELOW KNEE TOTAL CNTC2142.25NANA 509Carrier 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 MECH2142.25NANA 510Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5685ADD LOW EXT PROS BELW KNEE SUSP/SEAL SLEEVE EA2142.25NANA 511Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910ADD ENDOSKEL SYSTEM BELOW KNEE ALIGNABLE SYSTEM2142.25NANA 512Carrier L2020DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5940ADD ENDOSKEL SYSTEM BELW KNEE ULTRA-LGHT MATL2142.25NANA 513Carrier 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)810309NANA 514Carrier 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)80.88948NANA 515Carrier 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)80.75996NANA 516Carrier 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)70.713.4361.71NANA 517Carrier 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)170.654.2425.41NANA 518Carrier 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 PRO110.646.5528.36NANA 519Carrier 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)80.63963NANA 520Carrier 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); LUMBAR80.63969NANA 521Carrier 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; LUMBAR80.63945NANA 522Carrier 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 INTE180.56444NANA 523Carrier 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)810309NANA 524Carrier 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 PERFORMED713.4348NANA 525Carrier 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);71024NANA 526Carrier 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 COORDINATIO7110.2948NANA 527Carrier 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)80.88948NANA 528Carrier 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)80.75996NANA 529Carrier 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)170.654.2425.41NANA 530Carrier 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 PRO110.646.5528.36NANA 531Carrier 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)80.63963NANA 532Carrier 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 INTE180.56444NANA 533Carrier 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 C27142.71NANA 534Carrier 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)90.8997.2484.54NANA 535Carrier 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)270.8297.2461.33NANA 536Carrier 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)110.8264.01NANA 537Carrier 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)140.7166.08NANA 538Carrier 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); lumbar200.7194.3682.72NANA 539Carrier 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)100.797.2477.6NANA 540Carrier 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)180.67194.3691.31NANA 541Carrier 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; lumbar150.67194.3679.52NANA 542Carrier 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)110.5597.24113.88NANA 543Carrier 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 C27142.71NANA 544Carrier 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)6149.55NANA 545Carrier 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);513.5130.44NANA 546Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction411.1626.16NANA 547Carrier 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)3137.93NANA 548Carrier 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)3177.56NANA 549Carrier 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)210.130.13NANA 550Carrier 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; lumbar2141.48NANA 551Carrier 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; lumbar2141.48NANA 552Carrier A2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22855Removal of anterior instrumentation2122.48NANA 553Carrier 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)1100.0964.01NANA 554Carrier 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; lumbar1500.07194.3679.52NANA 555Carrier 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)1800.06194.3691.31NANA 556Carrier 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); lumbar2000.05194.3682.72NANA 557Carrier 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)2700.0497.2461.33NANA 558Carrier 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)140066.08NANA 559Carrier 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)110097.24113.88NANA 560Carrier 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)100097.2477.6NANA 561Carrier 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)600194.3654.79NANA 562Carrier 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)40091.05NANA 563Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44120REMOVAL OF SMALL INTESTINE210NANA 564Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44625REPAIR BOWEL OPENING110NANA 565Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33416REVISE VENTRICLE MUSCLE110NANA 566Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61582CRANIOFACIAL APPROACH SKULL110NANA 567Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58952RESECT OVARIAN MALIGNANCY1124NANA 568Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38571LAPAROSCOPY LYMPHADENECTOMY110NANA 569Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303MAST SIMPLE COMPLETE1172NANA 570Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44139MOBILIZATION OF COLON1124NANA 571Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633LUMBAR SPINE FUSION COMBINED20.560NANA 572Carrier N2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49320DIAG LAPARO SEPARATE PROC2096NANA 573Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44120REMOVAL OF SMALL INTESTINE210NANA 574Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44625REPAIR BOWEL OPENING110NANA 575Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33416REVISE VENTRICLE MUSCLE110NANA 576Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61582CRANIOFACIAL APPROACH SKULL110NANA 577Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58952RESECT OVARIAN MALIGNANCY1124NANA 578Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571LAPAROSCOPY LYMPHADENECTOMY110NANA 579Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303MAST SIMPLE COMPLETE1172NANA 580Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44139MOBILIZATION OF COLON1124NANA 581Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633LUMBAR SPINE FUSION COMBINED20.560NANA 582Carrier N2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49320DIAG LAPARO SEPARATE PROC2096NANA 583Carrier 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)12169.74161.590NANA 584Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49000EXPLORATORY LAPAROTOMY-CELIOTOMY WITH OR WITHOUT BIOPSY91086.560NANA 585Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION81044.850NANA 586Carrier 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 PUMP817.6883.30NANA 587Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130HIP JOINT REPLACEMENT BY PROSTHESIS OR ARTIFICIAL JOINT230.96035.550NANA 588Carrier 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 DEFORMITY120.92064.480NANA 589Carrier 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 FLANGES160.88068.910NANA 590Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT OF DONOR OR SYNTHETIC MATERIAL-ADD ON120.83045.250NANA 591Carrier 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 SPINE150.67043.10NANA 592Carrier B2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048ADDITIONAL VERTEBRAL LAMINECTOMY, FACETECTOMY, and FORAMINOTOMY PROCEDURES100.6049.270NANA 593Carrier 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)12169.74161.590NANA 594Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49000EXPLORATORY LAPAROTOMY-CELIOTOMY WITH OR WITHOUT BIOPSY91086.560NANA 595Carrier 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 KNEE810127.470NANA 596Carrier 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 PUMP817.6883.30NANA 597Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION81044.850NANA 598Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558ARTHRODESIS-ANTERIOR INTERBODY WITH MINI DISKECTOMYOF LUMBAR SPINE71036.390NANA 599Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571LAPAROSCOPY WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY710.7179.470NANA 600Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20936AUTOGRAFT DURING SPINAL SURGERY ONLY; LOCAL THRU SAME INCISION71038.30NANA 601Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22842PLACEMENT OF SPINAL INTRUMENTATION; 3 TO 6 VERTEBRAE SEGMENT61063.490NANA 602Carrier B2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47120HEPATECTOMY RESECTION OF LIVER; PART LOBECTOMY OF LIVER617.23251.890NANA 603Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61760STEREOTACTIC IMPLANT DEPTH ELECTRODES-CEREBRUM1010100.880NANA 604Carrier B2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22610THORACIC SPINE FUSION101000NANA 605Carrier 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 REGION101000NANA 606Carrier 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 PROCEDURE300.33091.230NANA 607Carrier 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 COMPARTMENTS300.33039.940NANA 608Carrier 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 SEGMENT600.17063.490NANA 609Carrier 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 SEGMENT700.14060.710NANA 610Carrier 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 PROCEDURES1000.1049.270NANA 611Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY5112.95128.38600NANA 612Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV990.996.42112.83NANA 613Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES55260.9840.54530.38NANA 614Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD116820.9737.54247.41NANA 615Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59514CESAREAN DELIVERY ONLY480.960.8855.73NANA 616Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y550.9566.05NANA 617Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAP SLEEVE GASTRECTOMY380.92140.76NANA 618Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1010.95.4434.69NANA 619Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU580.7453.131068.04NANA 620Carrier C2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD1540.5937.3270.48NANA 621Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY5112.95128.38NANA 622Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPARO RADICAL PROSTATECT2110.48121.39NANA 623Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58960EXPLORATION OF ABDOMEN2111.0121.99NANA 624Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT362SURGERY2010.1745.39NANA 625Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT656HOSPICE GEN INPT/NOT RESP181157.0273.52NANA 626Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61781SCAN PROC CRANIAL INTRA1711.1340.63NANA 627Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50543LAPARO PARTIAL NEPHRECTOM16112.5936.42NANA 628Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487REVISE/REPLACE KNEE JOINT15152.78178.65NANA 629Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE TO FEMALE141383.01NANA 630Carrier C2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27570FIXATION OF KNEE JOINT1410.744.28NANA 631Carrier 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 GRAF1012103.45NANA 632Carrier 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 THERMOTHERPY200.5483.88NANA 633Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33270INS/REP SUBQ DEFIBRILLATO300.3323.82596.94NANA 634Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22514PERQ VERTEBRAL AUGMENTATI300.3346.7347.14NANA 635Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33945TRANSPLANTATION OF HEART400.2581.76211.16NANA 636Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43645LAP GASTR BYPASS INCL SML800.13159.29NANA 637Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD15400.0237.3270.48NANA 638Carrier 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-Y5500.0266.05NANA 639Carrier 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 LU5800.0253.131068.04NANA 640Carrier C2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT120ROOM AND BOARD116820037.54247.41NANA 641Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400OBSTETRICAL CARE2713.8194.23NANA 642Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510CESAREAN DELIVERY2110.1177.22NANA 643Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE,LEVL I16162.12NANA 644Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT367SURGERY141162.31NANA 645Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES12040.9945.98NANA 646Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD48300.9737.0772.8NANA 647Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130TOTAL HIP ARTHROPLASTY440.7538.01339.93NANA 648Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y120.7531.32203.96NANA 649Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558LUMBAR SPINE FUSION150.5357.11613.99NANA 650Carrier D2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD880.5234.8774.87NANA 651Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400OBSTETRICAL CARE2713.8194.23NANA 652Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510CESAREAN DELIVERY2110.1177.22NANA 653Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE,LEVL I16162.12NANA 654Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT367SURGERY141162.31NANA 655Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTO1111.114.1NANA 656Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPARO RADICAL PROSTATECT10191.33NANA 657Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUM JNT TOTAL SHOULDER91127.07NANA 658Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620REPAIR BOWEL OPENING810.56170.91NANA 659Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY8128.443.63NANA 660Carrier D2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY7139.86NANA 661Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775LAP SLEEVE GASTRECTOMY900.22534.68NANA 662Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR1100.1876.86346.45NANA 663Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558LUMBAR SPINE FUSION1500.1357.11613.99NANA 664Carrier D2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD8800.0234.8774.87NANA 665Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT5157.1NANA 666Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT41NANA 667Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG314.5NANA 668Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9328INJECTION TEMOZOLOMIDE 1 MG2129.8NANA 669Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21NANA 670Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38240BONE MARROW STEM CELL TRANSPLANTATION, ALLOGENIC210.3NANA 671Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS2115.8NANA 672Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCQ5006HOSPICE CARE PROV INPATIENT HOSPICE FACILITY11NANA 673Carrier E2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ7187INJ VONWILLEBRND FACTOR CMPLX HUMN RISTOCETIN IU114.3600NANA 674Carrier 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 3110.1NANA 675Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT5157.1NANA 676Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT41NANA 677Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG314.5NANA 678Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9328INJECTION TEMOZOLOMIDE 1 MG2129.8NANA 679Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21NANA 680Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240BONE MARROW STEM CELL TRANSPLANTATION, ALLOGENIC210.3NANA 681Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS2115.8NANA 682Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5006HOSPICE CARE PROV INPATIENT HOSPICE FACILITY11NANA 683Carrier E2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ7187INJ VONWILLEBRND FACTOR CMPLX HUMN RISTOCETIN IU114.3NANA 684Carrier 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 3110.1NANA 685Carrier 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; lumbar210.816718.29NANA 686Carrier 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 allograft400.82055NANA 687Carrier 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)200.84361NANA 688Carrier 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)150.8289118.3NANA 689Carrier 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)180.78372NANA 690Carrier 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)370.762779NANA 691Carrier 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)160.7582NANA 692Carrier 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/GYN3550.722367NANA 693Carrier 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)200.73775NANA 694Carrier 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); lumbar220.682366NANA 695Carrier 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)1113767NANA 696Carrier 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; lumbar1013386NANA 697Carrier 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)71186NANA 698Carrier 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 performed714744NANA 699Carrier 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)51243NANA 700Carrier 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 performed4187NANA 701Carrier 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 performed4187NANA 702Carrier 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 performed4187NANA 703Carrier 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)4187NANA 704Carrier 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)4187NANA 705Carrier 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 prosthesis10126NANA 706Carrier 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)700.14186NANA 707Carrier 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; lumbar1000.13386NANA 708Carrier 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)1600.0682NANA 709Carrier 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/GYN35500.012367NANA 710Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General10132.6NANA 711Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR130.92159.9NANA 712Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047LAM FACETECTOMY AND FORAMOTOMY 1 SEGMENT LUMBAR110.91159NANA 713Carrier 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/LMBR100.9145.9NANA 714Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION130.85132.8NANA 715Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT130.8542.7NANA 716Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED120.83132NANA 717Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP110.8232.342.2NANA 718Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION110.82139.2NANA 719Carrier G2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD190.797.5133.6NANA 720Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General10132.6NANA 721Carrier 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 VEIN814108.3NANA 722Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST6114.443NANA 723Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9070CYCLOPHOSPHAMIDE 100 MG6117.964.1NANA 724Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY615.150.6NANA 725Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ1453INJECTION FOSAPREPITANT 1 MG5130.1114.9NANA 726Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL51135.6NANA 727Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS5145.9NANA 728Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61624TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS5118.7131NANA 729Carrier G2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36226SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY419.7160.1NANA 730Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue164Other Room & Board - Sterile Environment10173.9NANA 731Carrier 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 SEGMENTS101145.6NANA 732Carrier 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 SPX101241.7NANA 733Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27702ARTHROPLASTY ANKLE W/IMPLANT101241.7NANA 734Carrier 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 VNTRC10149.3NANA 735Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20680REMOVAL IMPLANT DEEP300.6742.5141.8NANA 736Carrier G2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue206Intensive Care - Intermediate (ICU)200.550.1NANA 737Carrier 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 NTRSPC300.33103.8NANA 738Carrier 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 - General1000.332.6NANA 739Carrier 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 ROBOT400.255.170.1NANA 740Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27487Revis.totl Knee Arthroplas,w/wo Allogft;10152.8NANA 741Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27134Revis.tot.hip Arthropl;both Compnts9190NANA 742Carrier 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)310.9748135.77NANA 743Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Replacement Knee Total850.9182.05NANA 744Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple1160.91244NANA 745Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy490.9110.4NANA 746Carrier 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 C2420.86875.13NANA 747Carrier 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; Lumbar430.7324102.92NANA 748Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrod,interbdy Tech;lumbar,allogf650.67117.33NANA 749Carrier H2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy W Facetectomy-lumbar310.5594.86NANA 750Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487Revis.totl Knee Arthroplas,w/wo Allogft;10152.8NANA 751Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134Revis.tot.hip Arthropl;both Compnts9190NANA 752Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22802Arthrod,post,spin.deform,gft;7+vert7161.71NANA 753Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75894Transcatheter Therapy Embolize Any Meth6168.57NANA 754Carrier 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; Lumbar512467.2NANA 755Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22804Arthrodesis, 13 Or More Vertebral Segments41100.8NANA 756Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38241Hematopoietic Progenitor Cell (hpc);autologous Transplantation412464NANA 757Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27486Revis.totl Knee Arthroplas;1 Compon4136NANA 758Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63056Transped App/decomp;sgle;lumb3172NANA 759Carrier H2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy W Facetectomy-cervical504884NANA 760Carrier 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 C242010.33333375.13NANA 761Carrier 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)31012135.77NANA 762Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex Op Male To Female801121.6NANA 763Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22600Fusion Cervical Post < C18011153NANA 764Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22630Arthrodesis Post Interbody-lumbar701154NANA 765Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22614Arthrodesis, Each Additional Vertebral Segment401216NANA 766Carrier 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)101108NANA 767Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT38999Unlisted Proc Hemic/lymphatic Syst101272NANA 768Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22214Osteotomy Spine Post Appr-lumbar10172NANA 769Carrier H2020Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple11600.91244NANA 770Carrier 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 allograft7123.04667278NANA 771Carrier 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)5121.82893333NANA 772Carrier 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);311.39000000151.785NANA 773Carrier 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)3113.96756852NANA 774Carrier 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)110.9113.08NANA 775Carrier 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)40.757.796146042NANA 776Carrier 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 segment30.679.986528055NANA 777Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47600Cholecystectomy;4068.6544444546.25231454NANA 778Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47605Cholecystectomy; with cholangiography3068.6544444535.73902736NANA 779Carrier I2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis3072.79083333NANA 780Carrier 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 allograft7123.05NANA 781Carrier 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)5121.83NANA 782Carrier 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);311.3951.79NANA 783Carrier 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)3113.97NANA 784Carrier 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 component21139.77NANA 785Carrier 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))2169.77NANA 786Carrier 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)2133.62199.4NANA 787Carrier 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)210.09NANA 788Carrier 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)210.41NANA 789Carrier 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; lumbar2154.14NANA 790Carrier 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; lumbar2133.62NANA 791Carrier 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 C2210.41NANA 792Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23470Arthroplasty, glenohumeral joint; hemiarthroplasty2123.7632.3NANA 793Carrier I2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)21205.43NANA 794Carrier 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)201205.43NANA 795Carrier 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; lumbar10167.21NANA 796Carrier 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)10122.11NANA 797Carrier 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)10167.21NANA 798Carrier 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; lumbar200.533.62NANA 799Carrier 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)200.533.62NANA 800Carrier 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; lumbar200.554.14NANA 801Carrier 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)500.221.83NANA 802Carrier 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 allograft640.860.8932.22NANA 803Carrier 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)310.840.7361.39NANA 804Carrier 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); lumbar250.80.1864.04NANA 805Carrier 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)280.790.1861.12NANA 806Carrier 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)270.7872.88NANA 807Carrier 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; lumbar340.770.1868.48NANA 808Carrier 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)310.7763.78NANA 809Carrier 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; lumbar220.7756.5NANA 810Carrier 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)540.740.3570.67NANA 811Carrier 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)250.720.1552.33NANA 812Carrier 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)7189.4817.8NANA 813Carrier 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 performed712.989.0436.7NANA 814Carrier J2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor71111.3527.3NANA 815Carrier 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 interpretation51106.12NANA 816Carrier 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)51123.06NANA 817Carrier 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, cervical4186.09NANA 818Carrier 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 component410.4152.8NANA 819Carrier 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); radiofrequency4189.51NANA 820Carrier 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)4153.19NANA 821Carrier 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)410.840.73NANA 822Carrier 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 compartment600.5168.88NANA 823Carrier 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 mesh300.33148.34NANA 824Carrier 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 graft300.33183.67NANA 825Carrier 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, interpret600.1785.74NANA 826Carrier 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 splint700.14142.47NANA 827Carrier 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 fixation700.14146.54NANA 828Carrier 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)1400.0759.64NANA 829Carrier 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)1900.050.1878.39NANA 830Carrier 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 C22100.050.7363.36NANA 831Carrier 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); lumbar2500.040.1864.04NANA 832Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Adult26915.972.1489.3NANA 833Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Adolescent4917.5828.31NANA 834Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Child15111.130.02NANA 835Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS714642.5NANA 836Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER516542.5NANA 837Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Inpatient Adult515.630.02NANA 838Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Inpatient Adult Intensive510.05213.9NANA 839Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Acute Inpatient Adult410.9642.5NANA 840Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Inpatient Detox Adult470.985.940.05NANA 841Carrier K2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR80.8846610NANA 842Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Adult26915.972.14NANA 843Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Adolescent4917.5828.31NANA 844Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Child15111.130.02NANA 845Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER5165NANA 846Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASUD Inpatient Adult515.630.02NANA 847Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Inpatient Adult Intensive510.05NANA 848Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Acute Inpatient Adult410.96NANA 849Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT317166NANA 850Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANTERIOR INTERBODY LUMBAR21070NANA 851Carrier K2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C221109NANA 852Carrier 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/DRUG4128.3568.2NANA 853Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG2128.35NANA 854Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96411CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG2128.35NANA 855Carrier L2020Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96415CHEMOTHERAPY ADMN IV INFUSION TQ EA HR2168.235NANA 856Carrier 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 HR2168.2NANA 857Carrier 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 CLSR2092.3NANA 858Carrier 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/DRUG4128.3568.2NANA 859Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96409CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG2128.35NANA 860Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96411CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG2128.35NANA 861Carrier L2020Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96415CHEMOTHERAPY ADMN IV INFUSION TQ EA HR2168.2NANA 862Carrier 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 HR2168.2NANA 863Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRMHResidential Mental Health190.741.372NANA 864Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalDAADetoxification450.530.572NANA 865Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalMENMental Health1120.510.2184NANA 866Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse530.451.721NANA 867Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalREHRehabilitation360.442.657NANA 868Carrier M2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalDARDrug & Alcohol Rehabilitation60.170NANA 869Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalDAADetoxification1614.5229.5NANA 870Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalDARDrug & Alcohol Rehabilitation1100NANA 871Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalMENMental Health570.980.4232.84NANA 872Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse240.961118NANA 873Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRMHResidential Mental Health240.791458NANA 874Carrier M2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalREHRehabilitation140.715.1477.14NANA 875Carrier 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 minutes1041.59NANA 876Carrier 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 minutes1041.59NANA 877Carrier N2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASubstance Abuse Residential3124NANA 878Carrier N2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADetox1124NANA 879Carrier N2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMental Health Inpatient1124NANA 880Carrier N2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASubstance Abuse Residential3124NANA 881Carrier N2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADetox1124NANA 882Carrier N2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMental Health Inpatient1124NANA 883Carrier B2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Psychiatric Admission1126.800NANA 884Carrier B2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Psychiatric Admission1126.800NANA 885Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE51164.53NANA 886Carrier 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 HOUR21350.4NANA 887Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT1189.12NANA 888Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT912OTHER THERAPY SERV11590.18NANA 889Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ACCOM SEMI-PRVT DETOX/2BD2300.9928.55183.66NANA 890Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ACCOM SEMI-PRVT 2 BED PSY7970.9822.57277.87NANA 891Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV2280.9732.67740NANA 892Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3010.8870.79321.87NANA 893Carrier 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 MINS30.67318.51NANA 894Carrier C2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH20.5852.84NANA 895Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE51164.53NANA 896Carrier 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 HOUR21350.4NANA 897Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT1189.12NANA 898Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT912OTHER THERAPY SERV11590.18NANA 899Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ACCOM SEMI-PRVT DETOX/2BD2300.9928.55183.66NANA 900Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ACCOM SEMI-PRVT 2 BED PSY7970.9822.57277.87NANA 901Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV2280.9732.67740NANA 902Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3010.8870.79321.87NANA 903Carrier 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 MINS30.67318.51NANA 904Carrier C2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH20.5852.84NANA 905Carrier C2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD30100.0170.79321.87NANA 906Carrier C2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT900OTHER THERAPY SERV2280032.67740NANA 907Carrier C2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT126ACCOM SEMI-PRVT DETOX/2BD2300028.55183.66NANA 908Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY1187.96NANA 909Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900PSYCH TREATMENTS GEN THER1900.9932.06NANA 910Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ROOM AND BOARD3370.9734423.7NANA 911Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ROOM AND BOARD910.9327.084.07NANA 912Carrier D2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3110.8939.95732.43NANA 913Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY1187.96NANA 914Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900PSYCH TREATMENTS GEN THER1900.9932.06NANA 915Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ROOM AND BOARD3370.9734423.7NANA 916Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ROOM AND BOARD910.9327.084.07NANA 917Carrier D2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3110.8939.95732.43NANA 918Carrier D2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT124ROOM AND BOARD33700.0134423.7NANA 919Carrier D2020Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD31100.0139.95732.43NANA 920Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC57117.5NANA 921Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION5121.2NANA 922Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV319.7NANA 923Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0005ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN1126.2NANA 924Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99284EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY1145.8NANA 925Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue129ROOM & BOARD, SEMIPRIVATE TWO-BED - OTHER1168.2NANA 926Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP100.933.2NANA 927Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC120.8326.1NANA 928Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99255INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN1072.4NANA 929Carrier E2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue136ROOM & BOARD, THREE AND FOUR BEDS - DETOXIFICATION1098.4NANA 930Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC57117.5NANA 931Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION5121.2NANA 932Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV319.7NANA 933Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0005ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN1126.2NANA 934Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99284EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY1145.8NANA 935Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue129ROOM & BOARD, SEMIPRIVATE TWO-BED - OTHER1168.2NANA 936Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue114ROOM & BOARD, PRIVATE - PSYCHIATRIC11NANA 937Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP100.933.2NANA 938Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC120.8326.1NANA 939Carrier E2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99255INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN1072.4NANA 940Carrier F2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric312039NANA 941Carrier F2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation80.751638NANA 942Carrier F2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric312039NANA 943Carrier F2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation80.751638NANA 944Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE21117.5NANA 945Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY2165NANA 946Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric11NANA 947Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue450Emergency Room - General10432NANA 948Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue424Physical Therapy - Evaluation or Reevaluation10NANA 949Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue259Pharmacy - Other Pharmacy10NANA 950Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue440Speech-Language Pathology - General10NANA 951Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue300Laboratory - General10NANA 952Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue730EKG/ECG (Electrocardiogram) - General10NANA 953Carrier G2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue636Drugs Requiring Specific Identification - Drug Requiring Det10NANA 954Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE21117.5NANA 955Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY2164.3NANA 956Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric110NANA 957Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General11146.3NANA 958Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue259Pharmacy - Other Pharmacy10NANA 959Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue450Emergency Room - General10NANA 960Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue440Speech-Language Pathology - General10NANA 961Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue636Drugs Requiring Specific Identification - Drug Requiring Det10NANA 962Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue730EKG/ECG (Electrocardiogram) - General10NANA 963Carrier G2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue214Coronary Care - Intermediate Coronary Care Unit (CCU)10NANA 964Carrier 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 - General101146.3NANA 965Carrier 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 diem3134800NANA 966Carrier H2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation60.673136NANA 967Carrier H2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric40.529NANA 968Carrier 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 diem3103480NANA 969Carrier H2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation60.673136NANA 970Carrier H2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric40.529NANA 971Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol And/Or Drug Services21132.43NANA 972Carrier 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 developed1121.85NANA 973Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services4024.56NANA 974Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services10142.44NANA 975Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services1043.35NANA 976Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99233Alcohol And/Or Drug Services10NANA 977Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720Alcohol And/Or Drug Services1067.56NANA 978Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0018Alcohol and/or other drug treatment program, per diem1073.15NANA 979Carrier J2020Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0010Psychiatric diagnostic evaluation10NANA 980Carrier 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, interpret10124.9NANA 981Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem21132.4342.4NANA 982Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791Psychiatric diagnostic evaluation1121.8514.4NANA 983Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services4024.5618.9NANA 984Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services10142.44NANA 985Carrier 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 developed1019.3NANA 986Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0010Alcohol And/Or Drug Services10NANA 987Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0018Alcohol And/Or Drug Services1073.15NANA 988Carrier 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, interpret1067.56NANA 989Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services1043.35NANA 990Carrier J2020Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services10124.9NANA 991Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE560.881.2954.86NANA 992Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318REDUCTION MAMMAPLASTY410.591.7614.63NANA 993Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)710.481.0156.79NANA 994Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)420.361.7175.43NANA 995Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89258CRYOPRESERVATION; EMBRYO420.311.7186.29NANA 996Carrier 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 SPECIFIED290.312.4882.76NANA 997Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION510.21.4164.47NANA 998Carrier M2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE610.161.1874.75NANA 999Carrier 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 EMBRYOS390.051.8578.77NANA 1000Carrier 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 EMBRYOS390.051.8570.77NANA 1001Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58322ARTIFICIAL INSEMINATION; INTRA-UTERINE2313.1365.74NANA 1002Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT1714.2431.06NANA 1003Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE560.881.2954.86NANA 1004Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499UNLISTED EVALUATION AND MANAGEMENT SERVICE160.884.527NANA 1005Carrier 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; LUMBAR230.783.1329.22NANA 1006Carrier 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, LUMBAR250.762.8832.64NANA 1007Carrier 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 TREATED270.742.6716.89NANA 1008Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318REDUCTION MAMMAPLASTY410.591.7614.63NANA 1009Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)710.481.0156.79NANA 1010Carrier M2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)420.361.7175.43NANA 1011Carrier 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 CYCLE20112NANA 1012Carrier 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 INTERPRETATION200.6712NANA 1013Carrier 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 METHOD200.512NANA 1014Carrier 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 INTERPRETATION200.512NANA 1015Carrier 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, CERVICAL200.448NANA 1016Carrier 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 LEG100.3348NANA 1017Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58974EMBRYO TRANSFER, INTRAUTERINE200.2912NANA 1018Carrier 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 SPECIFIED200.112NANA 1019Carrier M2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89258CRYOPRESERVATION; EMBRYO200.0712NANA 1020Carrier 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)200.0512NANA 1021Carrier A2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Computed tomography, abdomen and pelvis; without contrast material3040.9410.55.5NANA 1022Carrier 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 echocardiography2800.915.8NANA 1023Carrier 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 material2290.884.5NANA 1024Carrier 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)1240.876.1NANA 1025Carrier 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 material1940.789.5NANA 1026Carrier 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 flexibility5500.779.922.8NANA 1027Carrier 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)1620.7716.224.4NANA 1028Carrier 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 minutes5050.751223.6NANA 1029Carrier 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 minutes2410.7324.7NANA 1030Carrier 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 activities2880.7125.5NANA 1031Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29827Arthroscopy, shoulder, surgical; with rotator cuff repair26167.57NANA 1032Carrier 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)1413.61NANA 1033Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303Transthoracic echocardiography for congenital cardiac anomalies; complete1311.73NANA 1034Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77046Magnetic resonance imaging, breast, without contrast material; unilateral12120.092.04NANA 1035Carrier 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 material1210.02NANA 1036Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72125Computed tomography, cervical spine; without contrast material1112.82NANA 1037Carrier A2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction11145.32NANA 1038Carrier 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; thoracic915.38NANA 1039Carrier 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)915.33NANA 1040Carrier 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)915.92NANA 1041Carrier 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)9155.22NANA 1042Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT42145Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)10193.99NANA 1043Carrier 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 guidance101173.5NANA 1044Carrier 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 mesh101317.1NANA 1045Carrier A2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22899Unlisted procedure, spine101101.25NANA 1046Carrier 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)400.50.44188.61NANA 1047Carrier 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, cervical400.50.44188.61NANA 1048Carrier 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 coupling200.581.09NANA 1049Carrier 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)200.517.01NANA 1050Carrier 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 mesh500.4206.86NANA 1051Carrier 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)500.4217.56NANA 1052Carrier 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; bilateral22112NANA 1053Carrier 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 sequences510.9612NANA 1054Carrier 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 level220.9512NANA 1055Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Computed tomography, abdomen and pelvis; with contrast material(s770.9112NANA 1056Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, any joint of lower extremity; without contrast materia810.8812NANA 1057Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260Computed tomography (CT), thorax; with contrast material(s)570.8812NANA 1058Carrier 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 sequences240.8312NANA 1059Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141MRI, spinal canal and contents, cervical; without contrast material400.8212NANA 1060Carrier N2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI spinal canal and contents, lumbar; without contrast material520.6912NANA 1061Carrier 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)300.6712NANA 1062Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63650Percutaneous implantation of neurostimulator electrode array, epidural12112NANA 1063Carrier 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 calcium12112NANA 1064Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ1745INFLIXIMAB NOT BIOSIMIL 10MG10172126NANA 1065Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY814861.7NANA 1066Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63042LAMINOTOMY SINGLE LUMBAR4112NANA 1067Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ3380INJECTION, VEDOLIZUMAB4112NANA 1068Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION4112NANA 1069Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213OFFICE O/P EST LOW 20-29 MIN4190NANA 1070Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30465REPAIR NASAL STENOSIS4166NANA 1071Carrier N2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29999Unlisted procedure, arthroscopy4112NANA 1072Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue551SKILLED NURSING VISIT IN HOME1260.9818.97129.960NANA 1073Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99601HOME INFUSION/SPCAILTY DRUG ADMINISTRATION-SKILLED NURSE VISIT1090.90129.610NANA 1074Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION OF ONABOTULINUMTOXINA990.8722.83206.590NANA 1075Carrier 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 SACRAL800.8434.84234.690NANA 1076Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFNITIVE DRUG TEST FOR DRUG CLASSES 8-142020.634.4899.430NANA 1077Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT VISIT ESTABLISHED1330.56103.53261.342.78NANA 1078Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT0296TEXTENDED ECG RECORDING710.55219.48153.640.15NANA 1079Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFNITIVE DRUG TEST FOR DRUG CLASSES 1-71480.530118.50NANA 1080Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0483DEFNITIVE DRUG TEST FOR DRUG CLASSES 22+1390.370116.460NANA 1081Carrier B2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0482DEFNITIVE DRUG TEST FOR DRUG CLASSES 15-211340.360113.640NANA 1082Carrier 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 MINUTES67100.030NANA 1083Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5101INJECTION OF FILGRASTIM-SNDZ(ZARXIO), BIOSIMILAR 1 MICROGRAM53111.1767.280NANA 1084Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30520SEPTOPLASTY OF DEVIATED SEPTUM4112.67119.350NANA 1085Carrier 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 MINUTES261000NANA 1086Carrier 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 MINUTES251000NANA 1087Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2350INJECTION OF OCRELIZUMAB 1 MG16124.03125.10NANA 1088Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9299INJECTION OF NIVOLUMAB 1 MG13114.8696.290NANA 1089Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9306INJECTION OF PERTUZUMAB, 1 MG13122.4381.970NANA 1090Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5119INJ RITUXIMAB-PVVR(RUXIENCE) BIOSIMILAR RUXIENCE 10 MG13180.7191.250NANA 1091Carrier B2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66982EXTRACAPSULAR CATARACT REMOVAL WITH COMPLEX TECHNIQUE AND DEVICES121059.790NANA 1092Carrier 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 EXAM301000.22NANA 1093Carrier 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 ELSEWHERE101000NANA 1094Carrier 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 TECHNIQUE101000NANA 1095Carrier 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 BIOPSIES101000NANA 1096Carrier 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 MINUTES101074.310NANA 1097Carrier 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 MG101000NANA 1098Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36415COLLECTION VENOUS BLOOD VENIPUNCTURE101000NANA 1099Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11104PUNCH BIOPSY SKIN SINGLE LESION101000NANA 1100Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80053COMPREHENSIVE METABOLIC PANEL101000NANA 1101Carrier B2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99203OFFICE/OUTPATIENT VISIT NEW PATIENT200.50313.770.07NANA 1102Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT31050.991.7613.32NANA 1103Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT44160.9816.25178.1NANA 1104Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY20220.987.76136.31NANA 1105Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235UPPER GI ENDO DX (SEP PROC)16860.9713.06159.87NANA 1106Carrier 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 MINS524960.9617.59126.64NANA 1107Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN32300.9625.88156.24NANA 1108Carrier 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 MINS23670.9317.17250.08NANA 1109Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10130130.9122.27228.84NANA 1110Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES47920.8517.51227.26NANA 1111Carrier C2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE44300.8315.79189.24NANA 1112Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76885ECHOGRAPHY OF INFANT HIPS, DYNAMIC18318.05110.96NANA 1113Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73222MRI JOINT UPR EXTREM W/ DYE17318.8885.93NANA 1114Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT91034GASTROESOPHAGEAL REFLUX TEST154122.14320.84NANA 1115Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76642ULTRASOUND BREAST LIMITED15011.4337.94NANA 1116Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93971BACK OFFICE DUPLEX SCAN, VEINS, UNILATERAL12218.5181.04NANA 1117Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58300INSERT INTRAUTERINE DEVICE10816.32124.43NANA 1118Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93922UPR/L XTREMITY ART 2 LEVE107113.3160.33NANA 1119Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93880DUPLEX SCAN EXTRACRANIAL,BILAT10216.7269.06NANA 1120Carrier C2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78227HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ9013.3277.16NANA 1121Carrier 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 DOC83110.9319.69NANA 1122Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81479UNLISTED MOLELCULAR PATHOLOGY PROCEDURE9400.0568.34658.76NANA 1123Carrier 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 COL53300.0243.07541.01NANA 1124Carrier 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 DUODENUM18800.0229.52297.51NANA 1125Carrier 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 DUO14200.0237.07682.69NANA 1126Carrier 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 MIN88000.0138.47291.57NANA 1127Carrier 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, NOS48500.0127.82332.51NANA 1128Carrier C2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78815TUMORIMAGE PET/CT SKUL-THIGH45500.0133.73441.52NANA 1129Carrier 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 MINS524960017.59126.64NANA 1130Carrier 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 EXERCISES47920017.51227.26NANA 1131Carrier 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 10130130022.27228.84NANA 1132Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT1328118.22114.75NANA 1133Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI JNT OF LWR EXTRE W/O54311.657.01NANA 1134Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT ABD & PELV W/CONTRAST49712.3268.72NANA 1135Carrier 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 MINS115030.9913.4184.68NANA 1136Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY8510.9917.13227.02NANA 1137Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN5140.9917.29163.46NANA 1138Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES7810.9818.93195.01NANA 1139Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 1018430.9719.78222.38NANA 1140Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES11760.9729.19126.32NANA 1141Carrier D2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE6430.9758.09226.44NANA 1142Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN STEM W/O & W/DY43512.8291.38NANA 1143Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73221MAGNETIC RESONANCE (EG, PROTON) JOINT28412.872.68NANA 1144Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77080DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE26718.11202.78NANA 1145Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71260COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/CONTRAST MATERIAL(S)26716.37124.48NANA 1146Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN STEM W/O DYE250114.16189.13NANA 1147Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI NECK SPINE W/O DYE23210.7890.43NANA 1148Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378DIAGNOSTIC COLONOSCOPY21119.5371.09NANA 1149Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70010MYLOGRAPHY POSTERIOR FOSSA COMPLETE19518.23249.34NANA 1150Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11102TANGNTL BX SKIN SINGLE LE19111.62117.94NANA 1151Carrier D2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70486CT MAXILLOFACIAL W/O DYE18412.16102.29NANA 1152Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ7330CULTURED CHONDROCYTES IMP300.671631.68NANA 1153Carrier 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 GUIDE300.67427.26NANA 1154Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT SIMPLE W/COMP500.437.28840.14NANA 1155Carrier D2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19318BREAST REDUCTION6300.0371.94450.34NANA 1156Carrier 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 BI33100.0222.68293.71NANA 1157Carrier 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 NOS20900.0232.07318.62NANA 1158Carrier 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, NOS35400.0135.69334.59NANA 1159Carrier 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 COL24400.0145.43594.55NANA 1160Carrier 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 DYE4620014.08122.05NANA 1161Carrier 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 1018430019.78222.38NANA 1162Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS7210.320NANA 1163Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNAPT IN THE HOME PER DIEM7018.3NANA 1164Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES860.990.514.4NANA 1165Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL720.974.827.2NANA 1166Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS7490.9610.519.4NANA 1167Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES4100.961.225.9NANA 1168Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN1030.950.527.2NANA 1169Carrier 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 MIN3020.8939.6NANA 1170Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98940CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS1650.7639.2NANA 1171Carrier E2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES680.6311.435.2NANA 1172Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS7210.320NANA 1173Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131PT IN THE HOME PER DIEM7018.3NANA 1174Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST58111.315.3NANA 1175Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040MEDICAL GENETICS COUNSELING EACH 30 MINUTES48129.1NANA 1176Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST37117.316.5NANA 1177Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN NO CONTRAST3610.116.1NANA 1178Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST2911.58.5NANA 1179Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES28110.736.1NANA 1180Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97813ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN26132NANA 1181Carrier E2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74177CT ABD AND PELVIS W CONTRAST2617.128.7NANA 1182Carrier 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 MINUTES200.550.5NANA 1183Carrier 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 LESION400.2553.2NANA 1184Carrier 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 MINUTES6800.0311.435.2NANA 1185Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A60100NANA 1186Carrier 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 cyclophotocoagulation620.9430123NANA 1187Carrier 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)540.9437127NANA 1188Carrier F2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple4810.913098NANA 1189Carrier 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 level860.912111NANA 1190Carrier 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 performed750.911994NANA 1191Carrier 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)3800.930980NANA 1192Carrier 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 allograft690.95194NANA 1193Carrier 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.1190.6136113NANA 1194Carrier 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.1980.3134920NANA 1195Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A6010.35NANA 1196Carrier 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 Time2019.33NANA 1197Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71260Computed Tomography, Thorax, Diagnostic; With Contrast Material(s)2016.26NANA 1198Carrier 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 incisions1714583NANA 1199Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70491Ct,soft Tissue Neck;w/contrast Mat.11116NANA 1200Carrier 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)91NANA 1201Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157Mri Spinal Canal Wo & W Contrast; Thorac9125.41NANA 1202Carrier 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 Sequences71NANA 1203Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72156Mri Spinal Wo & W Contrast: Cerv7129NANA 1204Carrier F2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Psychotherapy, 60 Minutes With Patient6184NANA 1205Carrier 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.exerc32012486NANA 1206Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350Reconstruct Nipple/areolar Unil40172NANA 1207Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15877Suction Assist Lipectomy Trunk10184NANA 1208Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19303Mastectomy Simple Complete40172NANA 1209Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex Op Male To Female301112NANA 1210Carrier F2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT54520Orchiectomy Simple Unilat10116120NANA 1211Carrier 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)10197NANA 1212Carrier 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 panniculectomy10196NANA 1213Carrier 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, cervical101118NANA 1214Carrier 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)101118NANA 1215Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19325BREAST AUGMENTATION WITH IMPLANT1198.2NANA 1216Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63030LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR111NANA 1217Carrier 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 VEIN10NANA 1218Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT52310CYSTO W/SIMPLE REMOVAL STONE and STENT1045.8NANA 1219Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49329UNLISTED LAPAROSCOPIC PX ABD PERTONEUM AND OMENTUM100.6NANA 1220Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20902BONE GRAFT ANY DONOR AREA MAJOR/LARGE10107.2NANA 1221Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43621GSTRCT TOT W/ROUX-EN-Y RCNSTJ1016.7NANA 1222Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21040EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL and CURT10107.2NANA 1223Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49905OMENTAL FLAP INTRA-ABDOMINAL100.6NANA 1224Carrier G2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER1089.8NANA 1225Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63030LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR111NANA 1226Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE1198.2NANA 1227Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325BREAST AUGMENTATION WITH IMPLANT1198.2NANA 1228Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49905OMENTAL FLAP INTRA-ABDOMINAL100.6NANA 1229Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21040EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL and CURT10107.2NANA 1230Carrier 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 LT10107.2NANA 1231Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER1089.8NANA 1232Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49329UNLISTED LAPAROSCOPIC PX ABD PERTONEUM AND OMENTUM100.6NANA 1233Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31536LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE106NANA 1234Carrier G2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52310CYSTO W/SIMPLE REMOVAL STONE and STENT1045.8NANA 1235Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home Sleep Test W/type Iii Portable Monitor30120.973.7NANA 1236Carrier 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 Performed49490.963.71NANA 1237Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A24930.965NANA 1238Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy Flexible, Transoral; With Biopsy, Single Or Multiple19830.9416.3547.47NANA 1239Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Ct Abd & Pelvis W/o Contrast50420.931.715.72NANA 1240Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic Resonance Imaging, Any Jnt-lowe42150.877.35NANA 1241Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity22180.848.38NANA 1242Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri,spin.canal,cerv;w/o Contrst Mat18080.8410.45NANA 1243Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri,spin.canal,lumb;w/o Cntrst Matl31010.83189.720NANA 1244Carrier H2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTMSMPTPhysical Therapy111860.71139NANA 1245Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically Aided Anter,cruciate Li15117281.43NANA 1246Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75557Cardiac Mri For Morph5014NANA 1247Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75572Ct Heart Contrast Eval Cardiac Structure&morph361NANA 1248Carrier 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 Stomac3311848NANA 1249Carrier 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 Lumbar2812470.55NANA 1250Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77790Supervise,handle,load Radioelement26115NANA 1251Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77761Intracavitary Radioelement Application;s26115NANA 1252Carrier 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)26115NANA 1253Carrier H2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38241Hematopoietic Progenitor Cell (hpc);autologous Transplantation25196105.88NANA 1254Carrier 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 Revision23185.39NANA 1255Carrier 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 Sinus1790143.277.29NANA 1256Carrier 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.seg169017294.97NANA 1257Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29888Arthroscopically Aided Anter,cruciate Li151017281.43NANA 1258Carrier 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 Performed66012474.48NANA 1259Carrier 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 Body540174.47NANA 1260Carrier 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 Removal490185.66NANA 1261Carrier 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 Sinus460178.21NANA 1262Carrier H2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31287Endoscopy, Surgical, With Sphenoidotomy44012498.71NANA 1263Carrier 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 Lat440161.576.36NANA 1264Carrier 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; Complex3901141.26NANA 1265Carrier 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 sequences1270.954.34NANA 1266Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test/type III Porta1260.954.34NANA 1267Carrier 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 echocardiography1540.923.42NANA 1268Carrier I2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Computed tomography, abdomen and pelvis; without contrast material2060.97.4NANA 1269Carrier 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 material1530.866.07NANA 1270Carrier 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 material1170.8517.358.48NANA 1271Carrier 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 flexibility3490.7722.4425.18NANA 1272Carrier 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 activities1340.76161.2124.25NANA 1273Carrier 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 minutes3500.7522.4424.49NANA 1274Carrier 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 minutes2130.7419.14NANA 1275Carrier 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 sequences2214.1NANA 1276Carrier 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 performed20129.441.6NANA 1277Carrier 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)1516.52NANA 1278Carrier 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; thoracic1514.56NANA 1279Carrier 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 level1410.17NANA 1280Carrier 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)1210.18NANA 1281Carrier 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)1019.42NANA 1282Carrier 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 allograft1017.16NANA 1283Carrier 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)9116.7741.5232.3NANA 1284Carrier 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 postprocessing912.29NANA 1285Carrier 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, cervical101115.68NANA 1286Carrier 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; cervical300.6753NANA 1287Carrier 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)200.5118.09NANA 1288Carrier 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 guidance500.42.5865.95NANA 1289Carrier 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 labrum300.3335.73NANA 1290Carrier 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)300.3338.49NANA 1291Carrier 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)400.2528.01NANA 1292Carrier 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; reducible400.2594.9NANA 1293Carrier 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, lumbar600.170.197.39NANA 1294Carrier I2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29828Arthroscopy, shoulder, surgical; biceps tenodesis700.1455.21NANA 1295Carrier 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 echocardiography22750.962.9504NANA 1296Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home sleep test/type III Porta15470.964.85NANA 1297Carrier 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 sequences13750.956.853.9NANA 1298Carrier J2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Computed tomography, abdomen and pelvis; without contrast material27890.932.845.07NANA 1299Carrier 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 material19550.870.216.06NANA 1300Carrier 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 material14730.850.296.88NANA 1301Carrier 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 minutes44100.7920.9830.65NANA 1302Carrier 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 flexibility54910.7815.3331.52NANA 1303Carrier 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 minutes51700.7823.6431.49NANA 1304Carrier 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 activities35300.7629.3432.36NANA 1305Carrier 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 report9110.317.8NANA 1306Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70490Computed tomography, soft tissue neck; without contrast material4315.07NANA 1307Carrier 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)3610.02NANA 1308Carrier 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)30171.66NANA 1309Carrier 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)2710NANA 1310Carrier 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 processing1911.58NANA 1311Carrier 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)1812.1819.6NANA 1312Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29898Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive1810.270.0327.3NANA 1313Carrier 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 based1712.1660.6436.7NANA 1314Carrier J2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70487Computed tomography, maxillofacial area; with contrast material(s)1711.65NANA 1315Carrier 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 fixation10169.12NANA 1316Carrier 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 protection101144.59NANA 1317Carrier 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 protection101144.59NANA 1318Carrier 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 vessel101144.59NANA 1319Carrier 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 margin400.5118.15NANA 1320Carrier 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 variant200.560.51NANA 1321Carrier 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 substance200.576.93NANA 1322Carrier 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 older500.479.28NANA 1323Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21121Genioplasty; sliding osteotomy, single piece500.476.91NANA 1324Carrier 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)600.33108.64NANA 1325Carrier 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 graft600.33189.47NANA 1326Carrier 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)300.3350.22NANA 1327Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27412Autologous chondrocyte implantation, knee300.3371.84NANA 1328Carrier J2020Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20999Unlisted procedure, musculoskeletal system, general300.3364.07NANA 1329Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, Complete with Doppler6661NANA 1330Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98941Chiropractic Care4320.993.5NANA 1331Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98943Chiropractic Care2200.992.75213.9NANA 1332Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Residential Adult1160.9712.961.19NANA 1333Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260CT THORAX WITH CONTRAST2470.96NANA 1334Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI Brain WITH & WITHOUT CONTRAST3480.95NANA 1335Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT ABDOMEN & PELVIS WITH CONTRAST4000.94NANA 1336Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI LOWER EXTREMITY JOINT WITHOUT CONTRAST3880.89NANA 1337Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE WITHOUT CONTRAST2750.81NANA 1338Carrier K2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI UPPER EXTREMITY JOINT WITHOUT CONTRAST2040.78NANA 1339Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAPsychological and Neuropsychological Test Administration54119.82NANA 1340Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA98942Chiropractic Care35148NANA 1341Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA98940Chiropractic Care32148NANA 1342Carrier 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 TQ29101.38NANA 1343Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Behavior Identification Assessments2715.97NANA 1344Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH IOP Adolescent2610.92NANA 1345Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Residential Eating Disorder Adult2512.9924.64NANA 1346Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Direct Care Codes2512.63NANA 1347Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA87660IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ23101.46NANA 1348Carrier K2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearNA87480IADNA CANDIDA SPECIES DIRECT PROBE TQ23101.46NANA 1349Carrier 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 TQ5716.52NANA 1350Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98940Chiropractic Care53184NANA 1351Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD760.9915.27.75NANA 1352Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE730.9918.167.47NANA 1353Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98941Chiropractic Care4020.9884NANA 1354Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98943Chiropractic Care2060.9784NANA 1355Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479UNLISTED MOLELCULAR PATHOLOGY PROCEDURE540.966.0635NANA 1356Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81420FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS480.6531.54NANA 1357Carrier L2020Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND690.5962.07NANA 1358Carrier 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 ATTND560.5959.9835NANA 1359Carrier 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 TQ5716.52NANA 1360Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239EGD TRANSORAL BIOPSY SINGLE/MULTIPLE4711.317.38NANA 1361Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC3611.1311.25NANA 1362Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45384COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS3013.78NANA 1363Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81374HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH1911.06NANA 1364Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM1610.10.58NANA 1365Carrier 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 LEVEL13121.36NANA 1366Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81220CFTR GENE ANALYSIS COMMON VARIANTS1310.13NANA 1367Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY12120.166.11NANA 1368Carrier L2020Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C10110.58NANA 1369Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM4011.8100.2NANA 1370Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT390.971.85217.85NANA 1371Carrier M2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS460.960.5278.26NANA 1372Carrier 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 MINUTES190.953.79990.32NANA 1373Carrier 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 MINUTES190.89-195.791784.84NANA 1374Carrier 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) A250.88-148.8744.96NANA 1375Carrier 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 MINUTES230.87-161.741562.09NANA 1376Carrier 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 MANAGEMENT200.653.6102NANA 1377Carrier 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 MANAGEMENT260.622.77216.92NANA 1378Carrier 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 SESSION280.612.57294.86NANA 1379Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM4011.8100.2NANA 1380Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT390.971.85217.85NANA 1381Carrier M2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS460.960.5278.26NANA 1382Carrier 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 MINUTES190.953.79990.32NANA 1383Carrier 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 MINUTES190.89-195.791784.84NANA 1384Carrier 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) A250.88-148.8744.96NANA 1385Carrier 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 MINUTES230.87-161.741562.09NANA 1386Carrier 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 MANAGEMENT200.653.6102NANA 1387Carrier 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 MANAGEMENT260.622.77216.92NANA 1388Carrier 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 SESSION280.612.57294.86NANA 1389Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services13115.518.2NANA 1390Carrier 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 patient3146.5NANA 1391Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction2150.5NANA 1392Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete2150.5NANA 1393Carrier 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 plan21276.9NANA 1394Carrier 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)211.1168NANA 1395Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours2129.5NANA 1396Carrier 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 minutes21276.9393.6NANA 1397Carrier 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 minutes21276.9466.29NANA 1398Carrier 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 minutes21276.9576NANA 1399Carrier 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; individual170.8223.7NANA 1400Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem80.756.8NANA 1401Carrier 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)202.922.1NANA 1402Carrier A2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15877Suction assisted lipectomy; trunk2050.5461NANA 1403Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services13115.518.2NANA 1404Carrier 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 patient3146.5NANA 1405Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction2150.5NANA 1406Carrier 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 minutes21276.9NANA 1407Carrier 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)211.1NANA 1408Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete2150.5NANA 1409Carrier 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 plan21276.9NANA 1410Carrier A2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours2129.5NANA 1411Carrier 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 minutes21276.9NANA 1412Carrier 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 minutes21276.9NANA 1413Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy41108.25NANA 1414Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS0201Substance Abuse Partial Hospitalization Program4124NANA 1415Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124NANA 1416Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program3124NANA 1417Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)2124.5NANA 1418Carrier N2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization1124NANA 1419Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy41108.25NANA 1420Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0201Substance Abuse Partial Hospitalization Program4124NANA 1421Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124NANA 1422Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program3124NANA 1423Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)2124.5NANA 1424Carrier N2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization1124NANA 1425Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY WITH PATIENT AND FAMILY 60 MINUTES1010156.670.11NANA 1426Carrier 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 PATIENT910187.72192.35NANA 1427Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM7127.2158.190NANA 1428Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0004BEHAVIORAL HEALTH COUNSELING AND THERAPY PER 15 MIN61052.620NANA 1429Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY WITH PAIENT AND FAMILY 45 MINUTES41104.4321.630.25NANA 1430Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY; SINGLE SEIZURE31080.110NANA 1431Carrier 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 WEEK210118.370NANA 1432Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES150.93095.290NANA 1433Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY WITH PATIENT WITH EVALUTATION/MANAGEMENT LASTING 45 MIN290.90104.220.16NANA 1434Carrier B2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES PER DIEM50.80136.090NANA 1435Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY WITH PATIENT AND FAMILY 60 MINUTES1010156.670.11NANA 1436Carrier 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 PATIENT910187.72192.35NANA 1437Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM7127.2158.190NANA 1438Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0004BEHAVIORAL HEALTH COUNSELING AND THERAPY PER 15 MIN61052.620NANA 1439Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY WITH PAIENT AND FAMILY 45 MINUTES41104.4321.630.25NANA 1440Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY; SINGLE SEIZURE31080.110NANA 1441Carrier 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 WEEK210118.370NANA 1442Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT110289.850NANA 1443Carrier 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 TREATMENT110198.10NANA 1444Carrier B2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESSMENT110145.130NANA 1445Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT141290.9946.32193.87NANA 1446Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT81090.9951.597.9NANA 1447Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS45440.9932.33199.89NANA 1448Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY12100.9974.93113.09NANA 1449Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS2060.98176.38NANA 1450Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH1650.98130.21NANA 1451Carrier 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 HOUR3230.95147.68248.79NANA 1452Carrier C2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES3010.91125.29585.12NANA 1453Carrier 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 HOUR1750.8765.84442.04NANA 1454Carrier 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 MINS2140.7953.58648.05NANA 1455Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96150ASSESS HLTH/BEHAVE INIT161129.94NANA 1456Carrier 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 MONTH1311047.05NANA 1457Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97803MED NUTRIT THRPY REASSESS PER 15 MIN71392.21NANA 1458Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN7191.2NANA 1459Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT41637.48NANA 1460Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING BILLED PER HR BY PHD2145.61NANA 1461Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95819EEG AWAKE & ASLEEP INCLUDE HYPERVENTILATION &/OR21137.98NANA 1462Carrier 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 INSTRUMNT211061.95NANA 1463Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96125COGNITIVE TEST BY HC PRO21355.82NANA 1464Carrier C2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0362TBHV ID SUPRT ASSMT EA 1521811.09NANA 1465Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT128ROOM AND BOARD10194.45NANA 1466Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ8999ORAL PRESCRIPTION DRUG CHEMO200.5765.04NANA 1467Carrier 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 & MGMT14400.0248.06462.93NANA 1468Carrier 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 MINS21400.0153.58648.05NANA 1469Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT141290046.32193.87NANA 1470Carrier C2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90834PSYCHOTHERAPY 45 MIN PATIENT81090051.597.9NANA 1471Carrier 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 SVCS45440032.33199.89NANA 1472Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT832123.30319625190.66NANA 1473Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT646137.9005566889.01NANA 1474Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS453133.43685336193.13NANA 1475Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY110173.56166692113.9NANA 1476Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES38124.4785427585.84NANA 1477Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT151887.26NANA 1478Carrier 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 HOUR350.9416.85305825192.17NANA 1479Carrier 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 HOUR820.9344.40416865452.8NANA 1480Carrier 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 MINS680.8427.44527833277.07NANA 1481Carrier D2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT470.7471.99097414349.24NANA 1482Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY110173.56166692113.9NANA 1483Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES38124.4785427585.84NANA 1484Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT151887.26NANA 1485Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT905BH/INTENS OP/PSYCH141200.31NANA 1486Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2014SKILLS TRAIN AND DEV, 15 MIN111693.3NANA 1487Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99201OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10911448.03NANA 1488Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS41194.34NANA 1489Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY31395.82NANA 1490Carrier D2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES31651.14NANA 1491Carrier 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 MINS3113.84NANA 1492Carrier 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 & MGMT4700.0471.99097414349.24NANA 1493Carrier 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 HOUR8200.0144.40416865452.80NANA 1494Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN51124.5216NANA 1495Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS39121.2NANA 1496Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION34119.2NANA 1497Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN20115.5600NANA 1498Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS17121.5NANA 1499Carrier 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 MIN16131.1NANA 1500Carrier 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 MIN14133.6NANA 1501Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES3050.9925.9NANA 1502Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION7350.9726.3NANA 1503Carrier E2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES330.9726.5NANA 1504Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN51124.5NANA 1505Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS39121.2NANA 1506Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION34119.2NANA 1507Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN20115.5NANA 1508Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS17121.5NANA 1509Carrier 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 MIN16131.1NANA 1510Carrier 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 MIN14133.6NANA 1511Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE1317.3NANA 1512Carrier E2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY13153.5NANA 1513Carrier 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 MIN10119.3NANA 1514Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem160.882372NANA 1515Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1000.82466NANA 1516Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem400.81968NANA 1517Carrier 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 management200.8355NANA 1518Carrier 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 session280.7910660NANA 1519Carrier 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 management230.781062NANA 1520Carrier 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 education410.713465NANA 1521Carrier F2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Psychotherapy, 60 minutes with patient220.45329118.3NANA 1522Carrier 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 minutes120.424290NANA 1523Carrier 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)120.332376NANA 1524Carrier 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 minutes1113595NANA 1525Carrier 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 minutes1012384NANA 1526Carrier 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 plan911692NANA 1527Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0032Mental health service plan development by nonphysician6185NANA 1528Carrier F2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2019Therapeutic behavioral services, per 15 minutes6185NANA 1529Carrier 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 minutes5135108NANA 1530Carrier 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)1198NANA 1531Carrier 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)11209NANA 1532Carrier 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 use1198NANA 1533Carrier 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)1175NANA 1534Carrier F2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837Psychotherapy, 60 minutes with patient2200.093291NANA 1535Carrier 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 hours10000.012466NANA 1536Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0297LOW DOSE CT SCAN FOR LUNG CANCER SCREENING530.8525.255.7NANA 1537Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY40.7525.2212.7NANA 1538Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG70.7148.6112NANA 1539Carrier 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 M70.7148.6112NANA 1540Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19325BREAST AUGMENTATION WITH IMPLANT70.7142.5NANA 1541Carrier 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 MN50.648.6107.6NANA 1542Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE FEMALE70.5764NANA 1543Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION90.4480.5NANA 1544Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT80307DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE80.3872.5NANA 1545Carrier G2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN5016.3NANA 1546Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81381HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP310NANA 1547Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0004BEHAVIORAL HEALTH CNSL AND THERAPY PER 15 MINUTES2177.7NANA 1548Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96164HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN2177.7NANA 1549Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035MENTAL HEALTH PARTIAL HOSP TX LT 24 HOURS2129.725.6NANA 1550Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92523EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION21175.3NANA 1551Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96165HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN2177.7NANA 1552Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350NIPPLE/AREOLA RECONSTRUCTION21110.7NANA 1553Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR21203.5NANA 1554Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380ELECTROLYSIS EPILATION EACH 30 MINUTES1199.8NANA 1555Carrier G2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL1123.5NANA 1556Carrier 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 HOUR101192.4NANA 1557Carrier 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 ARTICULATE101136.7NANA 1558Carrier 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 FUNCJ101136.7NANA 1559Carrier 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 COMPREHENSION200.5175.3NANA 1560Carrier 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 HR200.5203.5NANA 1561Carrier 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 HOURS200.529.725.6NANA 1562Carrier 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 MIN300.33203.5NANA 1563Carrier 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 HOUR300.33203.5NANA 1564Carrier 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 MIN300.33203.5NANA 1565Carrier 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 HOUR300.33203.5NANA 1566Carrier 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 Mgmt1530.9167NANA 1567Carrier 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 Management1550.864876NANA 1568Carrier 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.1700.584877146.3NANA 1569Carrier 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 Mgmt1530.9167.34NANA 1570Carrier 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 Management1550.864876.46NANA 1571Carrier 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.1700.584877.34NANA 1572Carrier 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 Mgmt15300.3367.34NANA 1573Carrier 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 Management15500.224876.46NANA 1574Carrier 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)500.21792NANA 1575Carrier 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.17000.14877.34NANA 1576Carrier 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 diem4400.026568NANA 1577Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours10120.6423.2NANA 1578Carrier 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 management8137.06NANA 1579Carrier 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 session8137.06NANA 1580Carrier 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 management8137.06NANA 1581Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem6157.31NANA 1582Carrier I2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services70.8619.54NANA 1583Carrier 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; individual120.830.6135.61NANA 1584Carrier 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 minutes20.572.67NANA 1585Carrier 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 minutes20.520.86NANA 1586Carrier 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 abnormalities20.575.45NANA 1587Carrier 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 minutes20.520.86NANA 1588Carrier 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 minutes20.520.86NANA 1589Carrier 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 flexibility20.572.02352NANA 1590Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours10120.6423.2NANA 1591Carrier 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 session8137.061.6NANA 1592Carrier 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 management8137.06NANA 1593Carrier 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 management8137.06NANA 1594Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem6157.31NANA 1595Carrier 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 sequences110NANA 1596Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions111.68NANA 1597Carrier 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 minutes110.3815.5NANA 1598Carrier 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)1175.4523NANA 1599Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete1146.2923.5NANA 1600Carrier 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 analysis1175.45NANA 1601Carrier 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 activities110.3820.8NANA 1602Carrier 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 variant1175.458.7NANA 1603Carrier 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 plan1120.8610.6NANA 1604Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction1146.2921.1NANA 1605Carrier 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) alleles1175.45NANA 1606Carrier 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 material11024NANA 1607Carrier I2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450Computed tomography, head or brain; without contrast material11010.6NANA 1608Carrier 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);11182.15NANA 1609Carrier 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 Hours100020.6423.2NANA 1610Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services2350.9928.4417.34NANA 1611Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem1050.9242.57NANA 1612Carrier J2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours960.9235.9460.64NANA 1613Carrier 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 management660.8522.3845.15NANA 1614Carrier 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 management570.8125.3938.91NANA 1615Carrier 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 session760.7919.4943.53NANA 1616Carrier 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 minutes480.7574.9NANA 1617Carrier 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; individual2480.7457.33NANA 1618Carrier 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 minutes490.7473.43NANA 1619Carrier 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)590.6870.31NANA 1620Carrier 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 sequences51018.9NANA 1621Carrier 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 abnormalities5116.24NANA 1622Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450Computed tomography, head or brain; without contrast material514.2319.3NANA 1623Carrier 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) alleles4120.3NANA 1624Carrier 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)416.39NANA 1625Carrier 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 patient416.39NANA 1626Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes31126.07NANA 1627Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions310.84NANA 1628Carrier 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 Indicati3135.970.1NANA 1629Carrier 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)2184.87NANA 1630Carrier 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)2172.2815.3NANA 1631Carrier 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)210.0511.1NANA 1632Carrier J2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63650Percutaneous implantation of neurostimulator electrode array, epidural21130.1928.7NANA 1633Carrier 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 analysis2184.87NANA 1634Carrier 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 level21211.34NANA 1635Carrier 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.21107.44NANA 1636Carrier 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)21211.34NANA 1637Carrier 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.21185.21NANA 1638Carrier J2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT17380Electrolysis epilation, each 30 minutes300.33126.07NANA 1639Carrier 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 minutes1100.09103.21NANA 1640Carrier 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 minutes1200.0845.83NANA 1641Carrier 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 session7600.0319.4943.53NANA 1642Carrier 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 minutes4600.0277.58NANA 1643Carrier 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 plan4600.0265.18NANA 1644Carrier 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 minutes4800.0274.9NANA 1645Carrier 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 minutes4900.0273.43NANA 1646Carrier 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 management5700.0225.3938.91NANA 1647Carrier 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 management6600.0222.3845.15NANA 1648Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAPsychological and Neuropsychological Test Administration54119.82NANA 1649Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD IOP Adult1040.990.071.69NANA 1650Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Partial Adult1030.991.3815.18NANA 1651Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH IOP Adult930.999.08NANA 1652Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Partial Adult900.980.42.4835NANA 1653Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Detox Residential Adult540.980.664.09NANA 1654Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Residential Adult440.981.9214NANA 1655Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASUD Residential Adult1160.9712.961.19NANA 1656Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMH Partial Eating Disorder Adult320.976.912.18NANA 1657Carrier K2020Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAPsychological Testing670.9325.38NANA 1658Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAPsychological and Neuropsychological Test Administration54119.82NANA 1659Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Behavior Identification Assessments2715.97NANA 1660Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH IOP Adolescent2610.92NANA 1661Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Residential Eating Disorder Adult2512.9924.64NANA 1662Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Direct Care Codes2512.63NANA 1663Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH IOP Eating Disorder Adult2417.84NANA 1664Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAABA Qualified Health Professional Services2412.73NANA 1665Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Residential Adolescent2310.056.66NANA 1666Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMH Partial Eating Disorder Adolescent14122.6715.1NANA 1667Carrier K2020Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASUD Residential Adolescent1310.0424.09NANA 1668Carrier K2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMH Partial Adolescent2000.9540.45NANA 1669Carrier K2020Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANATranscranial Magnetic Stimulation (TMS)1700.5944.03NANA 1670Carrier 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 HARDWARE217202NANA 1671Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED217202NANA 1672Carrier 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 POUNDS217202NANA 1673Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPC92700UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE114801NANA 1674Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0951HEEL LOOP/HOLDER, WITH OR WITHOUT ANKLE STRAP, EACH114801NANA 1675Carrier 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, EACH114801NANA 1676Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, PREFABRICATED, INCLUDING FIXED HARDWARE, EACH114801NANA 1677Carrier M2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH119601NANA 1678Carrier 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, EACH114801NANA 1679Carrier 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 REDUCTION30.675603NANA 1680Carrier 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 HARDWARE217202NANA 1681Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED217202NANA 1682Carrier 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 POUNDS217202NANA 1683Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPC92700UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE114801NANA 1684Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0951HEEL LOOP/HOLDER, WITH OR WITHOUT ANKLE STRAP, EACH114801NANA 1685Carrier 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, EACH114801NANA 1686Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, PREFABRICATED, INCLUDING FIXED HARDWARE, EACH114801NANA 1687Carrier M2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH119601NANA 1688Carrier 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, EACH114801NANA 1689Carrier 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 REDUCTION30.675603NANA 1690Carrier 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)1019601NANA 1691Carrier 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 REDUCTION1002401NANA 1692Carrier 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 TYPE1004801NANA 1693Carrier 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 HARDWARE1009601NANA 1694Carrier 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 POUNDS1002401NANA 1695Carrier M2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9312INJECTION, RITUXIMAB, 10 MG12142012NANA 1696Carrier 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 PUMP200.9532.4020NANA 1697Carrier 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)140.9396014NANA 1698Carrier 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)90.787209NANA 1699Carrier 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; LUMBAR100.667.2010NANA 1700Carrier 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; LUMBAR120.58196012NANA 1701Carrier 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)130.5442.5013NANA 1702Carrier 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 INTE220.541.5022NANA 1703Carrier 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)140.534.3015NANA 1704Carrier 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 PRO130.4660.9013NANA 1705Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9312INJECTION, RITUXIMAB, 10 MG12142012NANA 1706Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9070CYCLOPHOSPHAMIDE, 100 MG917209NANA 1707Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9181INJECTION, ETOPOSIDE, 10 MG915609NANA 1708Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614SPINE FUSION, EXTRA SEGMENT814508NANA 1709Carrier M2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9000INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG816308NANA 1710Carrier 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 PUMP200.9532.4020NANA 1711Carrier 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)140.9396014NANA 1712Carrier 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)130.5442.5013NANA 1713Carrier 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 INTE220.541.5022NANA 1714Carrier 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)140.534.3014NANA 1715Carrier 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 INTE1100.6458.9011NANA 1716Carrier 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 PRO700.5761.707NANA 1717Carrier 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)700.4351.407NANA 1718Carrier 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)600.57206NANA 1719Carrier 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; LUMBAR500.681.605NANA 1720Carrier 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; LUMBAR400.7510804NANA 1721Carrier 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); LUMBAR300.337203NANA 1722Carrier 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)300.3314403NANA 1723Carrier M2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22216REVISE, EXTRA SPINE SEGMENT200.515602NANA 1724Carrier 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)200.52402NANA 1725Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRMHResidential Mental Health8198NANA 1726Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalMENMental Health2102NANA 1727Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalREHRehabilitation210.96.921NANA 1728Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse50.814.45NANA 1729Carrier M2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalDAADetoxification20.5242NANA 1730Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRMHResidential Mental Health81908NANA 1731Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalMENMental Health21002NANA 1732Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalREHRehabilitation210.96.9021NANA 1733Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalRSAResidential Substance Abuse50.814.405NANA 1734Carrier M2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalDAADetoxification20.52402NANA 1735Carrier M2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalREHRehabilitation2001202NANA 1736Carrier M2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalDAADetoxification1004801NANA 1737Carrier M2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalRSAResidential Substance Abuse100001NANA 1738Carrier 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 CYCLOPHOTOCOAGULATION101100101NANA 1739Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE5818.7058NANA 1740Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)670.9930.8067NANA 1741Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89258CRYOPRESERVATION; EMBRYO680.9730.4068NANA 1742Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION730.7578.2073NANA 1743Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318BREAST REDUCTION750.7322.4075NANA 1744Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)870.5554.9087NANA 1745Carrier M2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE820.3753.3082NANA 1746Carrier 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 EMBRYOS490.0452.9049NANA 1747Carrier 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 EMBRYOS480.0454048NANA 1748Carrier 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 CYCLOPHOTOCOAGULATION101100101NANA 1749Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4016FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE5818.7058NANA 1750Carrier 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 TREATED4419.8044NANA 1751Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)670.9930.8067NANA 1752Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89258CRYOPRESERVATION; EMBRYO680.9730.4068NANA 1753Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58322ARTIFICIAL INSEMINATION; INTRA-UTERINE310.937.9031NANA 1754Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4011IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION730.7578.2073NANA 1755Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318BREAST REDUCTION750.7322.4075NANA 1756Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT89253ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)870.5554.9087NANA 1757Carrier M2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE820.3753.3082NANA 1758Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS4022ASSISTED OOCYTE FERTILIZATION, CASE RATE5200.0236052NANA 1759Carrier 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 EMBRYOS470055.1047NANA 1760Carrier 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 EMBRYOS460056.3046NANA 1761Carrier 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)3900.0517.8039NANA 1762Carrier M2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19318BREAST REDUCTION2000.234.8020NANA 1763Carrier 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 IDENTIFICATION1800.0636018NANA 1764Carrier 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 TIP8004508NANA 1765Carrier 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;700.4378.907NANA 1766Carrier 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 GRAFTS6001206NANA 1767Carrier 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 WALL6003206NANA 1768Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS50114.4050NANA 1769Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT48135.5048NANA 1770Carrier M2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM20110.8020NANA 1771Carrier 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 MINUTES181766.7018NANA 1772Carrier 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 MINUTES181766.7018NANA 1773Carrier 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 MINUTES181766.7018NANA 1774Carrier 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) A17121.2017NANA 1775Carrier 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 MANAGEMENT280.68105.4028NANA 1776Carrier 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 MANAGEMENT380.66135.2038NANA 1777Carrier 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 SESSION380.66135.2038NANA 1778Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS50114.4050NANA 1779Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT48135.5048NANA 1780Carrier M2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM20110.8020NANA 1781Carrier 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 MINUTES181766.7018NANA 1782Carrier 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 MINUTES181766.7018NANA 1783Carrier 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 MINUTES181766.7018NANA 1784Carrier 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) A17121.2017NANA 1785Carrier 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 MANAGEMENT280.68105.4028NANA 1786Carrier 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 MANAGEMENT380.66135.2038NANA 1787Carrier 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 SESSION380.66135.2038NANA 1788Carrier 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 MANAGEMENT1300236.3013NANA 1789Carrier 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 SESSION1300236.3013NANA 1790Carrier 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 MANAGEMENT90018409NANA 1791Carrier 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 MINUTES1007201NANA 1792Carrier 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 MINUTES100302401NANA 1793Carrier A2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin41108.24013424NANA 1794Carrier A2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10160.53944441NANA 1795Carrier A2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10160.53944441NANA 1796Carrier A2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin41108.24013424NANA 1797Carrier A2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys10160.53944441NANA 1798Carrier A2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM10160.53944441NANA 1799Carrier 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)918.7027469139NANA 1800Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified21105.93138892NANA 1801Carrier 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]1960.971.340782313196NANA 1802Carrier 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)140.8619.0450595214NANA 1803Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal30.3362.685679913NANA 1804Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi110.18182.935585311NANA 1805Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu400.004386324NANA 1806Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B200.0102777792NANA 1807Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0950Tray200.0107291662NANA 1808Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware200.0104133342NANA 1809Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods2012.028396252NANA 1810Carrier 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 hardware200.0101509732NANA 1811Carrier A2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER2017.217592.8708333311NANA 1812Carrier 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)918.7027469139NANA 1813Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified21105.93138892NANA 1814Carrier 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]1960.971.340782313196NANA 1815Carrier 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)140.8619.0450595214NANA 1816Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal30.3362.685679913NANA 1817Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi110.18182.935585311NANA 1818Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781External Ambulatory Infus Pu400.004386324NANA 1819Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B200.0102777792NANA 1820Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0950Tray200.0107291662NANA 1821Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware200.0104133342NANA 1822Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods2012.028396252NANA 1823Carrier 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 hardware200.0101509732NANA 1824Carrier A2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER2017.217592.8708333311NANA 1825Carrier 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)7152.773943837NANA 1826Carrier 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)6167.903275816NANA 1827Carrier 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; lumbar5170.27620265NANA 1828Carrier 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); lumbar5170.460729865NANA 1829Carrier 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)80.8866.65170528NANA 1830Carrier 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 pump10041.1819590710NANA 1831Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9250Methotrexate Sodium Inj6034.90618656NANA 1832Carrier 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)5013.926455225NANA 1833Carrier 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)500.0207155565NANA 1834Carrier A2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS2068Breast DIEP flag reconstruct5013.926341675NANA 1835Carrier 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)113.798888891NANA 1836Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33976Insertion of ventricular assist device; extracorporeal, biventricular113.798888891NANA 1837Carrier 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 cardiectomy113.798888891NANA 1838Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33945Heart transplant, with or without recipient cardiectomy113.798888891NANA 1839Carrier A2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33979Insertion of ventricular assist device, implantable intracorporeal, single ventricle113.798888891NANA 1840Carrier 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 approach110.0044444451NANA 1841Carrier 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)7152.773943837NANA 1842Carrier 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)6167.903275816NANA 1843Carrier 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; lumbar5170.27620265NANA 1844Carrier 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); lumbar5170.460729865NANA 1845Carrier 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)4176.094735874NANA 1846Carrier 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)2157.42303992NANA 1847Carrier 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)2157.42303992NANA 1848Carrier 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))2112.813868472NANA 1849Carrier 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)2157.42303992NANA 1850Carrier 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, cervical1122.435352781NANA 1851Carrier 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 segments1125.190593611NANA 1852Carrier 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; lumbar1144.734119441NANA 1853Carrier 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 allograft1136.800075831NANA 1854Carrier 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; thoracolumbar110.0305555561NANA 1855Carrier 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)1171.779444441NANA 1856Carrier 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 interpretation111.7852777781NANA 1857Carrier 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; lumbar1125.190593611NANA 1858Carrier 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)1116.892009171NANA 1859Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric411.2341666661.45965305513NANA 1860Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder130.9262.6014766913NANA 1861Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services10102.21666671NANA 1862Carrier A2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA 1863Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric411.2341666661.45965305513NANA 1864Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder130.9262.6014766913NANA 1865Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services10102.21666671NANA 1866Carrier A2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA 1867Carrier 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 saturation1450.949.725153257145NANA 1868Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2510.936.9877404487202511NANA 1869Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis2260.9312.2330689226NANA 1870Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr2110.920.1086111128.6666181871210NANA 1871Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI, any joint of upper extremity; wo co1140.870.15305555511.9721320767211131NANA 1872Carrier A2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1590.8412.34567115159NANA 1873Carrier 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 minutes4740.7140.1486780640.976925553471NANA 1874Carrier 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 flexibility4960.740.1486780637.512929043493NANA 1875Carrier 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 minutes2460.6930.69431239.3489813243NANA 1876Carrier 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 activities2580.6816.5127629243.9106771762422561NANA 1877Carrier 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 allograft2218.48630940722NANA 1878Carrier 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)1810.03179659518NANA 1879Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1711.82465686317NANA 1880Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74174ct angio abd&pelv w/o&w/dye1617.78590277816NANA 1881Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70552Contrast MRI of brain15111.7094074115NANA 1882Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng1410.01448412714NANA 1883Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr14112.1179960314NANA 1884Carrier 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)13141.8107006713NANA 1885Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73720MRI, lower extremity other than joint; w1315.17068376113NANA 1886Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl1210.000069412NANA 1887Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction12134.010876512NANA 1888Carrier A2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70496CTA, head, w/o cntrst flwd by cntrst1217.94228632512NANA 1889Carrier 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)12132.9939050412NANA 1890Carrier A2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine15900.0212.34567115159NANA 1891Carrier 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 level7100.040.43715361127.52914773170NANA 1892Carrier 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 performed3400.0628.7597605934NANA 1893Carrier 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 joint1500.0728.1935554615NANA 1894Carrier 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; lumbar1000.10.04416666725.8061552419NANA 1895Carrier 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, lumbar800.130.195765222109.366673726NANA 1896Carrier 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)500.229.849551815NANA 1897Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12118.8224726312NANA 1898Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5113.010694445NANA 1899Carrier 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 minutes80.75101.50878238NANA 1900Carrier 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 activities40.7546.180559934NANA 1901Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-310.749.08145161331NANA 1902Carrier 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 session60.6734.47368696NANA 1903Carrier 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 management60.6734.441481486NANA 1904Carrier 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 management60.6734.47368696NANA 1905Carrier 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; individual180.3365.46100057648181NANA 1906Carrier 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)40.25125.25051764NANA 1907Carrier A2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834Psychotherapy, 45 minutes with patient4013.7121111111.8915456513NANA 1908Carrier 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)4013.712110284.34525898213NANA 1909Carrier 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; simple110.0102777771NANA 1910Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12118.8224726312NANA 1911Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5113.010694445NANA 1912Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131Physical therapy, in the home, per diem2123.161532922NANA 1913Carrier 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)211.4393579172NANA 1914Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences2144.526944442NANA 1915Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain2102NANA 1916Carrier 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 specifications310.01027777760.3120833312NANA 1917Carrier 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 abnormalities110.0094444461NANA 1918Carrier 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 minutes110.1788888891NANA 1919Carrier 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; complex1123.920277781NANA 1920Carrier 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; infrared110.1788888891NANA 1921Carrier 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 plan210.01027777723.9202777811NANA 1922Carrier A2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG6015RADIATION TX DELIVERY IMRT210.01055555596.7038888911NANA 1923Carrier 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-3100.039.08145161331NANA 1924Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXT AMB INFUSN PUMP INSULIN719656160NANA 1925Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT21036020NANA 1926Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8619COCH IMP EXT PROC/CONTR RPLC11096010NANA 1927Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8685IMPLT NROSTM PLS GEN SNG REC11024010NANA 1928Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11024010NANA 1929Carrier N2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE110168010NANA 1930Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44145PARTIAL REMOVAL OF COLON1101NANA 1931Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15734MUSCLE-SKIN GRAFT TRUNK1101NANA 1932Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21085PREPARE FACE/ORAL PROSTHESIS11241NANA 1933Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58543LSH UTERUS ABOVE 250 G1101NANA 1934Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTOMY1101NANA 1935Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32667THORACOSCOPY W/W RESECT ADDL1101NANA 1936Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61304OPEN SKULL FOR EXPLORATION11241NANA 1937Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47379LAPAROSCOPE PROCEDURE LIVER11481NANA 1938Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58954TAH RAD DEBULK/LYMPH REMOVE1101NANA 1939Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHRD CMBN 1NTRSPC LUMBAR50.6915NANA 1940Carrier N2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible0NANA 1941Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44145PARTIAL REMOVAL OF COLON1101NANA 1942Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734MUSCLE-SKIN GRAFT TRUNK1101NANA 1943Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21085PREPARE FACE/ORAL PROSTHESIS11241NANA 1944Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58543LSH UTERUS ABOVE 250 G1101NANA 1945Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTOMY1101NANA 1946Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32667THORACOSCOPY W/W RESECT ADDL1101NANA 1947Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61304OPEN SKULL FOR EXPLORATION11241NANA 1948Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47379LAPAROSCOPE PROCEDURE LIVER11481NANA 1949Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58954TAH RAD DEBULK/LYMPH REMOVE1101NANA 1950Carrier N2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047LAM FACETEC & FORAMOT LUMBAR11241NANA 1951Carrier N2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASubstance Abuse Residential31030NANA 1952Carrier N2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMental Health Inpatient11010NANA 1953Carrier N2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASubstance Abuse Residential31030NANA 1954Carrier N2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMental Health Inpatient11010NANA 1955Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA15132143120NANA 1956Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95806SLEEP STUDY UNATT&RESP EFFT410.97607.60410NANA 1957Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY530.943120167.12510NANA 1958Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM280.929057.40280NANA 1959Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE220.909038.20220NANA 1960Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA400.8524481390NANA 1961Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64999NERVOUS SYSTEM SURGERY110.8180113.50110NANA 1962Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM190.789073.30190NANA 1963Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI (eg, proton) ANY JOINT OF LOWER EXTREMITY160.750690160NANA 1964Carrier N2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ1745INFLIXIMAB NOT BIOSIMIL 10MG140.429090.90140NANA 1965Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA15132143120NANA 1966Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0299HHS/HOSPICE OF RN EA 15 MIN1010120100NANA 1967Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95800SLP STDY UNATTENDED9100090NANA 1968Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION9102.7090NANA 1969Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5121INJ. AVSOLA, 10 MG7100070NANA 1970Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS RF 1ST VEIN61072060NANA 1971Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION610400060NANA 1972Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0399HOME SLEEP TEST/TYPE 3 PORTA6100060NANA 1973Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0122INJ MENOTROPINS 75 IU6100600NANA 1974Carrier N2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0126INJ FOLLITROPIN ALFA 75 IU6100600NANA 1975Carrier N2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ1557GAMMAPLEX INJECTION300.3324010NANA 1976Carrier N2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67904REPAIR EYELID DEFECT10124010NANA 1977Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)4124040NANA 1978Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124030NANA 1979Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization2124020NANA 1980Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program2124020NANA 1981Carrier N2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy1169.25010NANA 1982Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868Transcranial Magnetic Stimulation (TMS)4124040NANA 1983Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480Mental Health Intensive Outpatient Program3124030NANA 1984Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035Psychiatric Treatment Partial Hospitalization2124020NANA 1985Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015Substance Abuse Intensive Outpatient Program2124020NANA 1986Carrier N2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Mental Health Individual and Family Therapy1169.25010NANA 1987Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM11187.5401100NANA 1988Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY830.9448.6106.0802810NANA 1989Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY210.972.6285.7301200NANA 1990Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN90.8979.040090NANA 1991Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING290.86119.7300290NANA 1992Carrier 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 TIME120.5157.4100120NANA 1993Carrier B2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY70.29137.890070NANA 1994Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM11187.5401100NANA 1995Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY830.9448.6106.0802810NANA 1996Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY210.972.6285.7301200NANA 1997Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN90.8979.040090NANA 1998Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING290.86119.7300290NANA 1999Carrier 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 TIME120.5157.4100120NANA 2000Carrier B2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY70.29137.890070NANA 2001Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP20121.48148.931190NANA 2002Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE121120.870120NANA 2003Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR9129.6682.34450NANA 2004Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE4910.9843.82101.6434870NANA 2005Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR1520.9711.975.63131380NANA 2006Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP300.9760.75123.582280NANA 2007Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP190.9569.8685.642170NANA 2008Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS720.8898.80.040721NANA 2009Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT TYPE USED NON-INVASIVE170.8221.4121.071160NANA 2010Carrier B2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108OTHER ACCESSORY100.8143.610100NANA 2011Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR9129.6682.340450NANA 2012Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399DURABLE MEDICAL EQUPMENT MISCELLANEOUS51112.210050NANA 2013Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4222SUPPLIES EXTERNAL DRUG INFUSION PUMP PER CASSETTE/BAG41152.560040NANA 2014Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510SPEECH GENERATING DEVICE/SYNTHIZED SPEECH, PERMITTING MULTIPLE METHODS OF MESSAGE FORMULATION31101.370030NANA 2015Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0007EXTRA HEAVY-DUTY WHEELCHAIR2184.450020NANA 2016Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4221SUPPLIES-MAINTAINCE DRUG INFUSION CATHETERS PER WEEK1169.450010NANA 2017Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCV5260HEARING AID, DIGITAL, BINAURAL, ITE11112.250010NANA 2018Carrier B2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2359POWER WHEELCHAIR ACCESSORY, GROUP 34 SEALED LEAD ACID BATTERY11193.220010NANA 2019Carrier 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 SYSTEM11153.350010NANA 2020Carrier 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 CLASSIFIED11124.40010NANA 2021Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0466HOME VENT TYPE USED NON-INVASIVE1700.0621.4121.0701160NANA 2022Carrier 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 ORTHOTIC300.330248.670030NANA 2023Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0652PNEUMATIC COMPRESS SEGMENTAL W ITH GRADIENT PRESS300.330392.910030NANA 2024Carrier B2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0668SEGMENTAL PNEUMATIC-USE W/COMPRESSOR FULL ARM200.50408.820020NANA 2025Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPORSCOPY REMOVAL OF PART OF THE COLON1112.1897.9801100NANA 2026Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECTOMY9186.770090NANA 2027Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT TO BONE DURING SPINAL SURGERY160.9445.4400160NANA 2028Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840INSTRUMENTATION INSERTED TO CORRECT A SPINAL SPACE120.9232.8400120NANA 2029Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614SPINAL FUSION TO JOIN TWO VERTEBRAE90.8958.920090NANA 2030Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearcPT22853METALLIC MESH BETWEEN VERTEBRAE170.8844.2700170NANA 2031Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT MATERIAL ATTACHED TO SPINE160.8847.9100160NANA 2032Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK70.8661.720070NANA 2033Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION90.7851.610090NANA 2034Carrier B2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047SINGLE VERTEBRAE LAMINECTOMY SURGERY70.7149.160070NANA 2035Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPAROSCOPIC PROCEDURE DONE DURING A PARTIAL COLECTOMY612.18132.150150NANA 2036Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9070CYCLOPHOSPHAMIDE 100MG41125.570040NANA 2037Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52332INSPECTION OF INSIDE OF BLADDER WITH A SCOPE1165.90010NANA 2038Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0538TT-LYMPHOCYTES FROZEN FOR TRANSPORT1129.180010NANA 2039Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0539TLABORTATORY RECEIPT AND PREP OF T-LYMPHOCYTES1129.180010NANA 2040Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49255OMENTECTOMY/EPIPLOECTOMY-RESECTION OMENTUM1142.680010NANA 2041Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0569TREPAIR OF MITRAL VLAVE DEFECT WITH PROTHESIS1195.570010NANA 2042Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58548LAPAROSCOPIC REMOVAL OF UTERUS, FALLOPIAN TUBES, OVARIES, AND LIGAMENTS1171.630010NANA 2043Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0570TREPAIR OF TRICUSPIC VALVE WITH PROSTHIC DEVICE1195.80010NANA 2044Carrier B2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61781INTRACRANIAL SCAN PERFORMED DURING INTERCRANIAL SURGERY1119.480100NANA 2045Carrier B2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22857LUMBAR ARTIFICAL DISKECTOMY101059.230010NANA 2046Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC410206.780040NANA 2047Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126SEMI-PRIVATE DETOXIFICATION BED INPATIENT2102.450020NANA 2048Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY110540010NANA 2049Carrier B2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY430.95026.1500410NANA 2050Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC410206.780040NANA 2051Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126SEMI-PRIVATE DETOXIFICATION BED INPATIENT2102.450020NANA 2052Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY110540010NANA 2053Carrier B2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY430.95026.1500410NANA 2054Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCQ5101INJ FILGRASTIM G-CSF BIOSIMULATOR61115.656.9120390NANA 2055Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue551SKILLED NURSE VISIT IN HOME1480.9964.88101.9101370NANA 2056Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ3489ZOLEDRONIC ACID 1MG640.9713.6652.4618450NANA 2057Carrier 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 LEVEL790.9143.40790NANA 2058Carrier 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 MACHINE1630.871.41152.1711620NANA 2059Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD1800.7823.73153.5111790NANA 2060Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION,ONABOTULINUMTOXINA1130.7626.15146.4641050NANA 2061Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN2010.6370.64124.250.05161814NANA 2062Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-7630.4175.290630NANA 2063Carrier B2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-14640.39175.260640NANA 2064Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5118INJECTION BEVACIZUMAB-BVCR BIOSIMILAR 10 MILLIGRAM (ZIRABEV)26124.0682.6205200NANA 2065Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9299INJECTION NIVOLUMAB 1 MILLIGRAM1914.06113.8706130NANA 2066Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9022INJECTION ATEZOLIZUMAB 10 MILLIGRAM11110.0176.680380NANA 2067Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81208BCR/ABL1 GENETIC TEST FOR CHROMOSOME 2231176.890030NANA 2068Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81257HBA1/HBA2 GENETIC TEST FOR ALPHA THALASSEMIA3169.440030NANA 2069Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2182INJECTION MEPOLIZUMAB 1MILLIGRAM21129.420020NANA 2070Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81256HFE GENE (HEMOCHROMATOSIS GENE) TEST FOR CHANGES2197.740020NANA 2071Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ0694INJECTION CEFOXITIN SODIUM 1 GRAM1122.230010NANA 2072Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81261IGH GENETIC TEST FOR LYMPHOID NEOPLASMS11117.750010NANA 2073Carrier B2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0491DIALYSIS ACUTE KIDNEY WITHOUT END STAGE RENAL DISEASE115.650100NANA 2074Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21209OSTEOPLASTY FACIAL BONES; REDUCTION1010270.06010NANA 2075Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77067SCREENING MAMMOGRAPHY3010000NANA 2076Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99213OFFICE/OUTPATIENT VISIT ESTABLISHED1010000NANA 2077Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT83605TEST FOR AMOUNTS OF LACTATE1010000NANA 2078Carrier 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 EXAM1010000NANA 2079Carrier 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 JOINT1010000NANA 2080Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77065DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED1010000NANA 2081Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11104PUNCH BIOPSY SKIN SINGLE LESION10101.17001NANA 2082Carrier B2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80053COMPREHENSIVE METABOLIC PANEL10100.07001NANA 2083Carrier 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 MINUTES10100.04003NANA 2084Carrier 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 PATIENT1010204.0100100NANA 2085Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM410113.310030NANA 2086Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM310159.130030NANA 2087Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201PARTIAL HOSPITALZTION SERVICES <24 HR-PER DIEM21074.530020NANA 2088Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES21031.890020NANA 2089Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY210445.40020NANA 2090Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES;METHADONE ADMINISTRATION/SERVICE110200.570010NANA 2091Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY SESSION UNDER 60 MINUTES11098.120010NANA 2092Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015INTENSIVE OUTPATIENT PROGRAM FOR CHEMICAL DEPENDENCY TREATMENT110136.870010NANA 2093Carrier B2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY240.920176.9100240NANA 2094Carrier 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 PATIENT1010204.0100100NANA 2095Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPT PSYCH SERV PER DIEM410113.310030NANA 2096Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM310159.130030NANA 2097Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY210445.40020NANA 2098Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0201PARTIAL HOSPITALZTION SERVICES <24 HR-PER DIEM21074.530020NANA 2099Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES21031.890020NANA 2100Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES;METHADONE ADMINISTRATION/SERVICE110200.570010NANA 2101Carrier 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 HOUR110236.250010NANA 2102Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY SESSION UNDER 60 MINUTES11098.120010NANA 2103Carrier B2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015INTENSIVE OUTPATIENT PROGRAM FOR CHEMICAL DEPENDENCY TREATMENT110136.870010NANA 2104Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE4730.99225341162NANA 2105Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN7180.97612015703NANA 2106Carrier 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 MINS21600.9655191611999NANA 2107Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG1280.9616435573NANA 2108Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD1170.957111170NANA 2109Carrier 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 SHOE2600.9316477253NANA 2110Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV850.9293472560NANA 2111Carrier 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=1D6290.859699373256NANA 2112Carrier C2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1860.839198522164NANA 2113Carrier 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 ACCESSORIES8270.801783426401NANA 2114Carrier 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 GL73117370NANA 2115Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5501DIABETIC CUSTOM MOLDED SHOE23147023NANA 2116Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11042DEBRIDE SKIN & SUBQ TISSUE161028115NANA 2117Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11721DEBRIDE NAIL(S) ANY METHOD(S) 6+917509NANA 2118Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN10102037NANA 2119Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92014COMPREHENSIVE EYE EXAM ESTABLISHED PT 1+ VISITS9192827NANA 2120Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93924NON-INVASIVE STUDY LE ARTERY POST T9103927NANA 2121Carrier 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 MINS81254226NANA 2122Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92134OCT MACULAR/RETINA W/INTERP & REPORT; UNIL/BILAT1211030102NANA 2123Carrier C2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762MISC SERVICES22113220NANA 2124Carrier 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 ACCESSORIES82700.009783426401NANA 2125Carrier 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=1D62900.006699373256NANA 2126Carrier 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 PUMP18600.022198522164NANA 2127Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND5590.99870559NANA 2128Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE21910.995130210388NANA 2129Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR6580.99431441617NANA 2130Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT6320.9891129623NANA 2131Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE36910.984282093482NANA 2132Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 025390.974527226313NANA 2133Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT6900.9731028354336NANA 2134Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL12520.957228669583NANA 2135Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH5740.953440290284NANA 2136Carrier C2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE47460.91644314853261NANA 2137Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3260POST-OP SHOE CANVAS2681074264NANA 2138Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1846KO W ADJ FLEX/EXT ROTAT MOLD1081071296NANA 2139Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0849TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE751120273NANA 2140Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL7520REPAIR PROSTH DEV LABOR PER 15 MIN721545963NANA 2141Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0156SEAT ATTACHMENT, WALKER11112265259NANA 2142Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4386WALKING BOOT, PREFAB, NONPNEUMATIC461333145NANA 2143Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0484OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEV, NONELEC, ANY TYPE, EACH4711321037NANA 2144Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0100CANES OF ANY MATERIAL4810131830NANA 2145Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4338INDWELLING CATH LATEX11711610215NANA 2146Carrier C2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0165COMMODE CHAIR STATIONARY4211292814NANA 2147Carrier 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 MINS21500.0051187501650NANA 2148Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA6549GRADIENT COMPRESSION STOCKING/SLEEVE NOS16500.0123489111540NANA 2149Carrier 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 TYPE2900.06922117.55240NANA 2150Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5700REPLACE SOCKET BEL KNEE PT MODEL2000.05131331190NANA 2151Carrier 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 MECH1900.0530801180NANA 2152Carrier 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; EA200.574.5020NANA 2153Carrier 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 ACCESS200311.5020NANA 2154Carrier C2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21089UNLISTED MAXILLOFACIAL PROSTH PROC10198010NANA 2155Carrier 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 LBS101306010NANA 2156Carrier 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 LOCKING10174100NANA 2157Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue367SURGERY72177072NANA 2158Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1200.9834296114NANA 2159Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD137310.97612371368843NANA 2160Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY340.9713201717NANA 2161Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV970.9497421384NANA 2162Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y330.90972033NANA 2163Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST510.882424843NANA 2164Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU260.65423160224NANA 2165Carrier 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 MINS310.6452676724NANA 2166Carrier C2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD1740.48913531731NANA 2167Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue367SURGERY72177072NANA 2168Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663THORACOSCOPY SURG W/ LOBECTOMY TOTAL/SEGMEN10103319NANA 2169Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970INTERSEX SURG MALE TO FEMALE916709NANA 2170Carrier 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 RING81708NANA 2171Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE10132237NANA 2172Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT9111827NANA 2173Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST14128104NANA 2174Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58210RAD ABD HYST W/ BILAT PEL LYMPHADENECTOMY81104244NANA 2175Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH711312861NANA 2176Carrier C2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762MISC SERVICES2310230NANA 2177Carrier C2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120ROOM AND BOARD1373100123713688430NANA 2178Carrier 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 RESECT1200.08311372100NANA 2179Carrier C2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD17400.023135317310NANA 2180Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD2390.992512390NANA 2181Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV3680.972423671NANA 2182Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3780.968253780NANA 2183Carrier C2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD8670.96711908634NANA 2184Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD2390.992512390NANA 2185Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV3680.972423671NANA 2186Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3780.968253780NANA 2187Carrier C2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD8670.96711908634NANA 2188Carrier C2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124ROOM AND BOARD86700.00211908634NANA 2189Carrier C2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue900OTHER THERAPY SERV36800.0052423671NANA 2190Carrier C2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD37800.003253780NANA 2191Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAMISC SERVICES63400.988114563391NANA 2192Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT76380CT SCAN LIMITED OR LOCALIZED F/U STUDY24580.9783176911767NANA 2193Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT108870.97721149510392NANA 2194Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY32630.9734174782785NANA 2195Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235UPPER GI ENDO DX (SEP PROC)31800.9692124072773NANA 2196Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE114980.9592525911239NANA 2197Carrier 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 MINS1082370.957191193596302NANA 2198Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN28840.9498271382746NANA 2199Carrier C2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES143140.909102474013574NANA 2200Carrier 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 MINS34720.88514445492923NANA 2201Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76885ECHOGRAPHY OF INFANT HIPS, DYNAMIC21711056210207NANA 2202Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9098HOME PHOTOTHERAPY VISIT77132077NANA 2203Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96160ADM OF HEALTH RISK ASSESS PATIENT FOCUS W/SCORE76114076NANA 2204Carrier 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 GUIDE8713192166NANA 2205Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11102TANGENTIAL BIOPSY OF SKIN; FIRST LESION751112966NANA 2206Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57420COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT;53107449NANA 2207Carrier 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)5618351838NANA 2208Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20670REM IMPLANT SUPERFICIAL (SEP PROC)5011261337NANA 2209Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58301REM IUD COMPLICATED W/DEVICE (NOT HEMOSTAT)451621837NANA 2210Carrier C2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT65855TRABECULOPLASTY LASER SURG 1+ SESSIONS4819221533NANA 2211Carrier 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 THERMOTHERPY700.286166070NANA 2212Carrier 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, ABDOMEN600.33325121150NANA 2213Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT42145PALATOPHARYNGOPLASTY500.4164050NANA 2214Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43499UNLISTED PROC ESOPHAGUS300.333133030NANA 2215Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99201.276REF PLASTIC SURGERY200.563020NANA 2216Carrier 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 ML200.5242020NANA 2217Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT, SIMPLE W/COMP500.428309410NANA 2218Carrier 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 APPROACH200.548289110NANA 2219Carrier C2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT85390FIBRINOLYSINS OR COAGULOPATHY101140100NANA 2220Carrier 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 MINS10125100NANA 2221Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT12370.99371941233NANA 2222Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS1240.99247571123NANA 2223Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS41880.9911864464142NANA 2224Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY10670.9944532131054NANA 2225Carrier 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 HOUR4010.98329445396NANA 2226Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT208640.981303922020644NANA 2227Carrier 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 HOUR1760.926501059167NANA 2228Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES6310.8594110649582NANA 2229Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT1670.832850167NANA 2230Carrier C2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES1290.791110813126NANA 2231Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT361111101135NANA 2232Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT12126012NANA 2233Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY 30 MIN PATIENT71113216NANA 2234Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97803MED NUTRIT THRPY REASSESS PER 15 MIN611506NANA 2235Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN5111005NANA 2236Carrier 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)3122003NANA 2237Carrier 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 MINS2115902NANA 2238Carrier 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 MINS21202NANA 2239Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90807IND PSYCHOTHERAPY OFFICE 45-50 MIN W/ E & M1128101NANA 2240Carrier C2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD11010NANA 2241Carrier C2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT2086400.0013039220206440NANA 2242Carrier 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 SVCS418800.00118644641420NANA 2243Carrier 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 HOUR17600.0065010591670NANA 2244Carrier 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 SERVICES12900.0311108231260NANA 2245Carrier 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 MINS4900.02302011480NANA 2246Carrier 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 102400.0422570240NANA 2247Carrier 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 MINS200.5123113110NANA 2248Carrier 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 MINS5660.99151638528NANA 2249Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE880.9893597315NANA 2250Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN1650.9883228157NANA 2251Carrier 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 SHOE730.986138172NANA 2252Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG640.9849281549NANA 2253Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD440.97714440NANA 2254Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG530.92515471340NANA 2255Carrier 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=1D2930.8028114163130NANA 2256Carrier D2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP850.74129129877NANA 2257Carrier 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 ACCESSORIES3910.7061297212179NANA 2258Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV261338521NANA 2259Carrier 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 MINS161124214NANA 2260Carrier 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 RECORDING10127010NANA 2261Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenueNAOTHER THERAPY SERV10102319NANA 2262Carrier 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 10914609NANA 2263Carrier 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 GL711707NANA 2264Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11719TRIMMING NONDYSTROPHIC NAILS ANY NUMBER614906NANA 2265Carrier 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 EA612906NANA 2266Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA12146193NANA 2267Carrier D2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenueNAMISC SERVICES17116170NANA 2268Carrier 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 ACCESSORIES39100.0112972121790NANA 2269Carrier 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=1D29300.0181141631300NANA 2270Carrier 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 PUMP8500.047291298770NANA 2271Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP2350.996150235NANA 2272Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE7310.99514569239NANA 2273Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR3640.9920173361NANA 2274Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT3350.991150335NANA 2275Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE8770.98622128849NANA 2276Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND2810.986210281NANA 2277Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0439STATIONARY LIQUID 022050.98153888117NANA 2278Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT1960.983359799NANA 2279Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL2930.966233138155NANA 2280Carrier D2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE18430.963403571486NANA 2281Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1833WARRIOR WRAP WITH HINGES/FLEX STOP971013196NANA 2282Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW911116289NANA 2283Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1830KO IMMOBILIZER CANVAS LONGIT78120078NANA 2284Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1812KNEE ORTHOSIS, ELAST W/JOINTS, PREFAB,OFF-THE-SHELF44117044NANA 2285Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN451540441NANA 2286Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4387WALKING BOOT, PREFAB, NONPNEUMATIC33112033NANA 2287Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE4913272227NANA 2288Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTV2624POLISHING ARTIFICAL EYE24141024NANA 2289Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB22129022NANA 2290Carrier D2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR6913295514NANA 2291Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0601CPAP DEVICE184300.00134035714860NANA 2292Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0114CRUTCHES METAL UNDERARM PAIR36400.00301733610NANA 2293Carrier 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 MINS5200.0191911914380NANA 2294Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0760OSTEOGEN U/S STIMLTOR3100.032241497240NANA 2295Carrier D2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0652PNEUMATIC COMPRESS SEGMNT W GRAD2100.0481141881200NANA 2296Carrier 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 LBS300.333138030NANA 2297Carrier 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 & COMP101100010NANA 2298Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV231078320NANA 2299Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue367SURGERY12183012NANA 2300Carrier 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 PUMP1211232210NANA 2301Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY13151649NANA 2302Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120ROOM AND BOARD59420.9691772590636NANA 2303Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV310.968122823NANA 2304Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU250.88187025NANA 2305Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y220.86472022NANA 2306Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAP SLEEVE GASTRECTOMY220.546109022NANA 2307Carrier D2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD720.36127720NANA 2308Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV231179320NANA 2309Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue367SURGERY12183012NANA 2310Carrier 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 PUMP1211232210NANA 2311Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY13151649NANA 2312Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST11174129NANA 2313Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST1110338NANA 2314Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO9131718NANA 2315Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32650THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA1011237NANA 2316Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364BREAST RECONSTRUCTION; WITH FREE FLAP911010027NANA 2317Carrier D2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE,LEVL I9112336NANA 2318Carrier D2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue120ROOM AND BOARD59420017725906360NANA 2319Carrier D2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775LAP SLEEVE GASTRECTOMY2200.0911090220NANA 2320Carrier D2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD7200.042277200NANA 2321Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912OTHER THERAPY SERV111001NANA 2322Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV2370.987132370NANA 2323Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD4450.98494450NANA 2324Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD1460.98281460NANA 2325Carrier D2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3730.979513730NANA 2326Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912OTHER THERAPY SERV111001NANA 2327Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue900OTHER THERAPY SERV2370.987132370NANA 2328Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM AND BOARD4450.98494450NANA 2329Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM AND BOARD1460.98281460NANA 2330Carrier D2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM AND BOARD3730.979513730NANA 2331Carrier D2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124ROOM AND BOARD44500.00294450NANA 2332Carrier D2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue128ROOM AND BOARD37300.003513730NANA 2333Carrier D2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue900OTHER THERAPY SERV23700.004132370NANA 2334Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT76380CT SCAN LIMITED OR LOCALIZED F/U STUDY13690.995213437932NANA 2335Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT21940.9937132221972NANA 2336Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73218MRI, UPPER EXTREMITY18620.993143151547NANA 2337Carrier 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 MINS243180.988519230322015NANA 2338Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE17600.9833411381722NANA 2339Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue762MISC SERVICES27610.9821527610NANA 2340Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES26790.9816151142565NANA 2341Carrier 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 MINS6630.97763190573NANA 2342Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL6510.8361247136515NANA 2343Carrier D2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72158MRI LUMBAR W/WO CONTRST SPINE8840.39626120149735NANA 2344Carrier 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 & REP14211229133NANA 2345Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT94010SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW12117119112NANA 2346Carrier 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 ECP127113116111NANA 2347Carrier 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 BLCK134121434100NANA 2348Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93797OPEN CARDIAC REHAB W/O CONT EKG MONITORING84113122777NANA 2349Carrier 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/STORAGE7111136566NANA 2350Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT26540REPAIR COLLAT LIGAMENT METACARPOPHALANGEAL/IP JNT7519231956NANA 2351Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93270EVENT MONITOR - HOOKUP RECORD & DISCON ONLY8513133154NANA 2352Carrier 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 LESS7012212248NANA 2353Carrier D2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77412RAD TX DELIVERY CUSTOM BLOCK 5 MEV9013164644NANA 2354Carrier 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-Y400.25171040NANA 2355Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT, SIMPLE W/COMP400.2598131130NANA 2356Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29916ARTHROSCOPY HIP W/LABRAL REPAIR400.25477130NANA 2357Carrier 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 THERMOTHERPY300.33387030NANA 2358Carrier 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 CM400.253582220NANA 2359Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67908REP BLEPHAROPTOSIS CONJU200.5202020NANA 2360Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77280THERAPEUTIC RADIOLOGY FIELD SIMPLE300.3332142210NANA 2361Carrier 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 DUODENOSCOSPY101105010NANA 2362Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27299UNLISTED PROC PELVIS/HIP JNT101125010NANA 2363Carrier D2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88381MICRODISSECTION; MANUAL10144100NANA 2364Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY1531260153NANA 2365Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT2480.99260248NANA 2366Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS6410.98813488633NANA 2367Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT27940.987825382756NANA 2368Carrier 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 HOUR640.953165262NANA 2369Carrier 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 HOUR810.92613199477NANA 2370Carrier 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 MINS230.913139122NANA 2371Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES260.88596026NANA 2372Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES1200.8834412712108NANA 2373Carrier D2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT770.83186077NANA 2374Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY1531260153NANA 2375Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE131109013NANA 2376Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES131106013NANA 2377Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS711407NANA 2378Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806.102REF MENTAL HEALTH EXTERNAL516305NANA 2379Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT216502NANA 2380Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY 30 MIN PATIENT1131701NANA 2381Carrier D2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR1130801NANA 2382Carrier 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 MINS117401NANA 2383Carrier 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 MINS11801NANA 2384Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT2794008253827560NANA 2385Carrier 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 HOUR8100.025131994770NANA 2386Carrier 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 & MGMT7700.039860770NANA 2387Carrier D2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS9480PSYCH SVC INTENSIVE OUTPT600.1671358150NANA 2388Carrier 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 ADMIM500.274050NANA 2389Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL37193.855.3136NANA 2390Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21197.121NANA 2391Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN191114.619NANA 2392Carrier 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=1D6128.96NANA 2393Carrier 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 DRESS1123.91NANA 2394Carrier 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 SERVICE1580.9627.7158NANA 2395Carrier E2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS360.8135.433.7333NANA 2396Carrier 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 subcutaneous510.3327.451NANA 2397Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL37193.855.3136NANA 2398Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21197.121NANA 2399Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN191114.619NANA 2400Carrier 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=1D6128.96NANA 2401Carrier 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 DRESS1123.91NANA 2402Carrier 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 SERVICE1580.9627.7158NANA 2403Carrier E2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS360.8135.433.7333NANA 2404Carrier 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 subcutaneous510.3327.451NANA 2405Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR7819.58.774.311661NANA 2406Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM3410.626.522.54282NANA 2407Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP ANY TYPE4211622.9339NANA 2408Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S1610.990.414.513.211564NANA 2409Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR1910.985.826.817.52214524NANA 2410Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR340.9735.70322NANA 2411Carrier 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 SHOE780.9752.133.24434NANA 2412Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION840.9445.752.6822NANA 2413Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1410.923.624.436141252NANA 2414Carrier E2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA6530GRADIENT COMPRESSION STK BELW KNEE 18-30 MMHG EA380.63117.735.3299NANA 2415Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR7819.58.774.311661NANA 2416Carrier 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/LESS26120.130.9251NANA 2417Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7005NONDISPOSABLE NEBULIZER SET2210.7210.11201NANA 2418Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM3410.626.522.54282NANA 2419Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP261313.9283212NANA 2420Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8015EXT BREASTPROSTHESIS GARMENT18162.720.2144NANA 2421Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP ANY TYPE4211622.9339NANA 2422Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1846KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM191291.857.9217NANA 2423Carrier E2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6212FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA26165.726NANA 2424Carrier 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 PANEL21119.921NANA 2425Carrier 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 EA3700.0392.337NANA 2426Carrier 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 31101NANA 2427Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT3120.235.112NANA 2428Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99223INITIAL HOSPITAL CARE/DAY 70 MINUTES210.12NANA 2429Carrier 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 31125.21NANA 2430Carrier 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 31101NANA 2431Carrier 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 21101NANA 2432Carrier 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 COMORBI110.11NANA 2433Carrier E2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA0302AMBULANCE BASIC EMERGENY ALL1101NANA 2434Carrier 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 COMORBIDITIES1121NANA 2435Carrier 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 COMORBIDITIES1152.11NANA 2436Carrier 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 31101NANA 2437Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50360RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT3120.235.112NANA 2438Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99223INITIAL HOSPITAL CARE/DAY 70 MINUTES210.12NANA 2439Carrier 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 31125.21NANA 2440Carrier 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 31101NANA 2441Carrier 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 21101NANA 2442Carrier 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 COMORBI110.11NANA 2443Carrier E2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA0302AMBULANCE BASIC EMERGENY ALL1101NANA 2444Carrier 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 COMORBIDITIES1121NANA 2445Carrier 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 COMORBIDITIES1152.11NANA 2446Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<1192.61NANA 2447Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT21126REFERRAL PORTLAND, REFERRALS EXTERNAL1130.91NANA 2448Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION3119.253.421NANA 2449Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION9180.249.154NANA 2450Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV7145.57NANA 2451Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC11139.411NANA 2452Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC48114.28.22424NANA 2453Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP290.93127.575.262.41622NANA 2454Carrier E2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES50.832.258.532NANA 2455Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<1192.61NANA 2456Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21126REFERRAL PORTLAND, REFERRALS EXTERNAL1130.91NANA 2457Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION3119.253.421NANA 2458Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION9180.249.154NANA 2459Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV7145.57NANA 2460Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC11139.411NANA 2461Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC48114.28.22424NANA 2462Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP290.93127.575.262.41622NANA 2463Carrier E2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES50.832.258.532NANA 2464Carrier 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 TQ101121.63.8992NANA 2465Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES43315.639.235.2839926NANA 2466Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS990.990.534.231.93924NANA 2467Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD1200.9827.8101191NANA 2468Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS9190.983.438.626.81386640NANA 2469Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT98940CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS1940.9745.1194NANA 2470Carrier 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 MIN3720.9642.613711NANA 2471Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN1030.9635.243.8985NANA 2472Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES950.967.937.520.34856NANA 2473Carrier E2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99211OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP1230.93.236.62441181NANA 2474Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97110THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES7610.835.44.93721NANA 2475Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN NO CONTRAST3016.344.727.317121NANA 2476Carrier 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 TQ101121.63.8992NANA 2477Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST3616.338.60.42862NANA 2478Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74177CT ABD AND PELVIS W CONTRAST28113.450.271918NANA 2479Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131PT IN THE HOME PER DIEM5919.359NANA 2480Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT87635IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ36124.936NANA 2481Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97813ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN35143.535NANA 2482Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98941CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS28144.928NANA 2483Carrier E2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST60110.535.93723NANA 2484Carrier 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 MIN37200.0142.613711NANA 2485Carrier E2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21126REFERRAL PORTLAND, REFERRALS EXTERNAL3700.032.673.256.73295NANA 2486Carrier 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 MINUTES6200.0246.943.5359NANA 2487Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES31156.769.8301NANA 2488Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES27135.80.8261NANA 2489Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS25143.96.4241NANA 2490Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE21145.26.3201NANA 2491Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION35139.9141520NANA 2492Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN22137.622NANA 2493Carrier 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 MIN19164.719NANA 2494Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES4590.9950.944.64563NANA 2495Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION13220.9839.861.3131111NANA 2496Carrier E2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN520.9862.452NANA 2497Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES31156.769.8301NANA 2498Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY W/PATIENT 30 MINUTES27135.80.8261NANA 2499Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS25143.96.4241NANA 2500Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE21145.26.3201NANA 2501Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE8147.579.762NANA 2502Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION35139.9141520NANA 2503Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN22137.622NANA 2504Carrier 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 MIN19164.719NANA 2505Carrier 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 MIN18144.718NANA 2506Carrier E2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0005ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN6139.36NANA 2507Carrier E2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION132200.00139.861.3131111NANA 2508Carrier F2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips280.615.7632.61622NANA 2509Carrier F2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips280.615.7632.61622NANA 2510Carrier F2021Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANATest Strips28005.7632.61622NANA 2511Carrier 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 adjustment7111207NANA 2512Carrier 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 supply330.9119122429NANA 2513Carrier 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-shelf100.9133010NANA 2514Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277Transmitter; external, for use with interstitial continuous glucose monitoring system180.8936114315NANA 2515Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis stimulator, electrical, noninvasive, other than spinal applications80.8611108NANA 2516Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infusion set for external insulin pump, nonneedle cannula type100.82615928NANA 2517Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin130.692815058NANA 2518Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous80.635215317NANA 2519Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0603Breast pump, electric (AC and/or DC), any type130.15186013NANA 2520Carrier F2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous positive airway pressure (CPAP) device80.1311008NANA 2521Carrier 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 adjustment7111207NANA 2522Carrier 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 fabricated61238815NANA 2523Carrier 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 section5111605NANA 2524Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1970Ankle-foot orthosis (AFO), plastic with ankle joint, custom fabricated516310714NANA 2525Carrier 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 accessories4111904NANA 2526Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each4111904NANA 2527Carrier F2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable4111804NANA 2528Carrier 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 type415010413NANA 2529Carrier 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-shelf416311213NANA 2530Carrier 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-shelf4110804NANA 2531Carrier F2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2999Lower extremity orthoses, not otherwise specified200.59902NANA 2532Carrier 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 only200.59902NANA 2533Carrier 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 unit10112201NANA 2534Carrier 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)110.822494110NANA 2535Carrier 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;140.712554311NANA 2536Carrier 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)270.72461324NANA 2537Carrier 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/GYN2440.67306557187NANA 2538Carrier 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)180.672557216NANA 2539Carrier 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; lumbar150.672348312NANA 2540Carrier 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)120.672556210NANA 2541Carrier 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); lumbar140.642465212NANA 2542Carrier 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)160.632555214NANA 2543Carrier 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)170.592534314NANA 2544Carrier 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);81334635NANA 2545Carrier F2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663Thoracoscopy, surgical; with lobectomy (single lobe)61178524NANA 2546Carrier 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; lumbar51259614NANA 2547Carrier 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 ring51426714NANA 2548Carrier 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)417611013NANA 2549Carrier 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)4168913NANA 2550Carrier 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)319503NANA 2551Carrier 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)312910512NANA 2552Carrier 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)31256412NANA 2553Carrier 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 segment31249612NANA 2554Carrier 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)2018602NANA 2555Carrier 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)20152711NANA 2556Carrier 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 diameter101510NANA 2557Carrier 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)101510NANA 2558Carrier F2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96549Unlisted chemotherapy procedure101610NANA 2559Carrier 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 diem112610NANA 2560Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5380.953311175463NANA 2561Carrier 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)4710.943511270401NANA 2562Carrier 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 level1400.913411318122NANA 2563Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92250Fundus photography with interpretation and report1340.93310926108NANA 2564Carrier 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 cyclophotocoagulation1380.89341124098NANA 2565Carrier 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 performed830.8930105974NANA 2566Carrier 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 allograft1140.82281191599NANA 2567Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation40.252140NANA 2568Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours2026511NANA 2569Carrier F2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric10501NANA 2570Carrier 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 performed57136110552NANA 2571Carrier 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 leg291102029NANA 2572Carrier 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)23130105419NANA 2573Carrier 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)20147115119NANA 2574Carrier 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 treated14198014NANA 2575Carrier 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 joint12175120111NANA 2576Carrier 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 cyclophotocoagulation14116104410NANA 2577Carrier 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 performed141349659NANA 2578Carrier 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)1111711238NANA 2579Carrier 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 sinus1113011347NANA 2580Carrier 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 diem112610NANA 2581Carrier F2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation40.252140NANA 2582Carrier 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 elbow400.257904NANA 2583Carrier 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; unilateral300.332415612NANA 2584Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex surgery; male to female200.510802NANA 2585Carrier 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 approach200.510802NANA 2586Carrier 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 stage200.517102NANA 2587Carrier F2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43999Unlisted procedure, stomach1019101NANA 2588Carrier 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)10122301NANA 2589Carrier 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 cm1012710NANA 2590Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem310.941560526NANA 2591Carrier 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 minutes200.91865119NANA 2592Carrier 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 education490.86166401039NANA 2593Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1080.8524662088NANA 2594Carrier 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 minutes250.842991520NANA 2595Carrier 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 plan250.842766718NANA 2596Carrier F2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem190.793382217NANA 2597Carrier 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 session290.721748128NANA 2598Carrier 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 management250.681748124NANA 2599Carrier 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 management160.631758115NANA 2600Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870Electroconvulsive therapy (includes necessary monitoring)216202NANA 2601Carrier 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 discussion21002NANA 2602Carrier 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.119501NANA 2603Carrier 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 patient112301NANA 2604Carrier 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 intramuscular111601NANA 2605Carrier 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.11001NANA 2606Carrier 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 discussion11001NANA 2607Carrier 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)112801NANA 2608Carrier F2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0013Esketamine, nasal spray, 1 mg112510NANA 2609Carrier 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 minutes230.873577815NANA 2610Carrier 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 hours12000.008254817103NANA 2611Carrier 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 minutes8500.01232991966NANA 2612Carrier 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 minutes8000.013321032060NANA 2613Carrier 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 EA3115.43NANA 2614Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA11140.31NANA 2615Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN230.8323.939.6518NANA 2616Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE50.86.469.214NANA 2617Carrier G2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC40.756.462.113NANA 2618Carrier 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 INSRT202NANA 2619Carrier 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 EA101NANA 2620Carrier 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 EA3115.43NANA 2621Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA11140.31NANA 2622Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN230.8323.939.6518NANA 2623Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE50.86.469.214NANA 2624Carrier G2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4232SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC40.756.462.113NANA 2625Carrier 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 INSRT202NANA 2626Carrier 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 EA101NANA 2627Carrier 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 INSULIN2300.17423.939.6518NANA 2628Carrier 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 TYPE500.26.469.214NANA 2629Carrier 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 3CC400.256.462.113NANA 2630Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1970AFO PLASTIC WITH ANKLE JOINT CUSTOM FABRICATED90.8953.29NANA 2631Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN230.8323.939.6518NANA 2632Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS90.78359NANA 2633Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM90.44104.29NANA 2634Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0667SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG80.3885.78NANA 2635Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA6550WND CARE SET NEG PRSS WND TX ELEC PUMP SPL110.3669.852.138NANA 2636Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE110.3669.852.138NANA 2637Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7000CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH110.3669.852.138NANA 2638Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS120.3378.512NANA 2639Carrier G2021DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3000FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA13028112NANA 2640Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7048VACUUM DRAINAGE COLLECTION UNIT AND TUBING KIT EA2117.42NANA 2641Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL1150.11NANA 2642Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL1150.11NANA 2643Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5514DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA3115.43NANA 2644Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA0425GROUND MILEAGE PER STATUTE MILE1191.31NANA 2645Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA0428AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT1191.31NANA 2646Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9270NONCOVERED ITEM OR SERVICE111201NANA 2647Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA11140.31NANA 2648Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0143WALKER FOLDING WHEELED ADJUSTABLE/FIXED HEIGHT1128.11NANA 2649Carrier G2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0261HOS BED SEMI-ELEC ANY TYPE SIDE RAIL W/O MATTRSS112131NANA 2650Carrier 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 PRSS1200.2578.512NANA 2651Carrier 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 INTF400.572.34NANA 2652Carrier 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 3CC400.256.462.113NANA 2653Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0241BATHTUB WALL RAIL EACH200.54.42NANA 2654Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0245TUB STOOL OR BENCH200.54.42NANA 2655Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA0425GROUND MILEAGE PER STATUTE MILE10191.31NANA 2656Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA0428AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT10191.31NANA 2657Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0143WALKER FOLDING WHEELED ADJUSTABLE/FIXED HEIGHT10128.11NANA 2658Carrier 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 MATL101126.81NANA 2659Carrier G2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0935CONTINUOUS PASSIVE MOT EXERCISE DEVC KNEE ONLY200.5168.611NANA 2660Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38724CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ1219.857.157NANA 2661Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS1016.7123.246NANA 2662Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General250.9678.10223NANA 2663Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE180.9415.682.8810NANA 2664Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST110.912711NANA 2665Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61510CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR110.911364.465NANA 2666Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61781STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL160.885.369.679NANA 2667Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD160.8166.264.1313NANA 2668Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION140.7926.368.3311NANA 2669Carrier G2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED150.7326.366.5312NANA 2670Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue200Intensive Care - General7107NANA 2671Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue110Room & Board - Private - General31113NANA 2672Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue113Room & Board - Private - Pediatric1146.21NANA 2673Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue122Room & Board - Semiprivate - 2 Beds - OB1149.51NANA 2674Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue127Room & Board - Semiprivate - 2 Beds - Oncology111NANA 2675Carrier 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 CM1114.71NANA 2676Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11042DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM OR LT2197.12NANA 2677Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11045DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM2197.12NANA 2678Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue206Intensive Care - Intermediate (ICU)51016741NANA 2679Carrier G2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue214Coronary Care - Intermediate Coronary Care Unit (CCU)4117.9031NANA 2680Carrier 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/GYN500.8189.615NANA 2681Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue113Room & Board - Private - Pediatric10146.21NANA 2682Carrier 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 - OB10149.51NANA 2683Carrier 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 MG1014.81NANA 2684Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ9181INJECTION ETOPOSIDE 10 MG1014.81NANA 2685Carrier G2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ9312INJECTION RITUXIMAB 10 MG1014.81NANA 2686Carrier 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 ARTERY400.5127.84NANA 2687Carrier 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/OVARY1011201NANA 2688Carrier 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 EXNTJ101195.31NANA 2689Carrier 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 EXTRADURAL101195.31NANA 2690Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99231SBSQ HOSPITAL CARE/DAY 15 MINUTES11241NANA 2691Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General1157.51NANA 2692Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES11241NANA 2693Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN OR LT11241NANA 2694Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57335VAGINOPLASTY INTERSEX STATE21169.32NANA 2695Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS21169.32NANA 2696Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT44955APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX1195.71NANA 2697Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric3124021NANA 2698Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15570FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK101NANA 2699Carrier G2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15877SUCTION ASSISTED LIPECTOMY TRUNK101NANA 2700Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue120Room & Board - Semiprivate - 2 Beds - General1157.51NANA 2701Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES11241NANA 2702Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99231SBSQ HOSPITAL CARE/DAY 15 MINUTES11241NANA 2703Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99238HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN OR LT11241NANA 2704Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS21338.62NANA 2705Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57335VAGINOPLASTY INTERSEX STATE21338.62NANA 2706Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44955APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX1195.71NANA 2707Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric3148021NANA 2708Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15570FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK101NANA 2709Carrier G2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15877SUCTION ASSISTED LIPECTOMY TRUNK101NANA 2710Carrier 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 - General10157.51NANA 2711Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61782STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL20.518.42NANA 2712Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31299UNLISTED PROCEDURE ACCESSORY SINUSES20.518.42NANA 2713Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC20.514.911NANA 2714Carrier 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 SPX20.514.911NANA 2715Carrier 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 THORACIC1043.61NANA 2716Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31622BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX202NANA 2717Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47120HEPATECTOMY RESCJ PARTIAL LOBECTOMY101NANA 2718Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT39561RESCJ DIAPHRAGM W/COMPLEX REPAIR101NANA 2719Carrier G2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE2043.620.611NANA 2720Carrier 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 VEIN2011NANA 2721Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44186LAPAROSCOPY SURGICAL JEJUNOSTOMY1114.91NANA 2722Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99222INITIAL HOSPITAL CARE/DAY 50 MINUTES1101NANA 2723Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99223INITIAL HOSPITAL CARE/DAY 70 MINUTES1101NANA 2724Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31040PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH1137.81NANA 2725Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31241NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY1137.81NANA 2726Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31255NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY1137.81NANA 2727Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31256NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY1137.81NANA 2728Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31257NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY1137.81NANA 2729Carrier 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 RMVL1137.81NANA 2730Carrier G2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31276NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS1137.81NANA 2731Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0011ALCOHOL and / DRUG SERVICES; ACUTE DTOX RES PROG IP15110.415NANA 2732Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN120.92105.512NANA 2733Carrier 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 MIN120.92105.512NANA 2734Carrier 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-DIEM130.9217.722112NANA 2735Carrier 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-1100.8637.195.84106NANA 2736Carrier 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 MN150.677715NANA 2737Carrier 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 M170.6571.9116NANA 2738Carrier 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 MIN110.6453.411NANA 2739Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG190.6371.9118NANA 2740Carrier G2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION170.4747.369.1314NANA 2741Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room & Board - Semiprivate - 2 Beds - Detoxification4124.34NANA 2742Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912Behavioral Health Treatments_Services - Partial hospitalizat2135.52NANA 2743Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue905Behavioral Health Treatments/Services -IOP Psychiatric11961NANA 2744Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81381HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP212NANA 2745Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906Behavioral Health Treatments/Services - IOP Chemical Depende1155.21NANA 2746Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL1171.41NANA 2747Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81380HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA111NANA 2748Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906Behavioral Health Treatments_Services - Intensive outpatient11481NANA 2749Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90846FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS1101NANA 2750Carrier G2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92521EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)116.91NANA 2751Carrier 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 - Detoxification400.2524.34NANA 2752Carrier 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-11000.00937.195.84106NANA 2753Carrier G2021Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION1700.05947.369.1314NANA 2754Carrier 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 PLAN10174.61NANA 2755Carrier H2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips1460.725.921.9129117NANA 2756Carrier H2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips1460.725.921.9129117NANA 2757Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/appliance Cusfab3290.993.710.150329NANA 2758Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width180.95100.364.18018NANA 2759Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair250.9275.843.16025NANA 2760Carrier 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)470.8869.232.88047NANA 2761Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr200.8556.352.35020NANA 2762Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified830.8783.25083NANA 2763Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1846Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens210.6268.312.85021NANA 2764Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications360.4881.233.38036NANA 2765Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (non-invasive)380.4379.353.31038NANA 2766Carrier H2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive330.0485.033.54033NANA 2767Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each1512498.82114NANA 2768Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination12160012NANA 2769Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-in-space, Rigid, Adj, Wo Seating5167.205NANA 2770Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2617Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type516805NANA 2771Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2609Custom Fabricated Wheelchair Seat Cushion, Any Size5182.2905NANA 2772Carrier 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)518405NANA 2773Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1002Wheelchair Accessory, Power Seating System, Tilt Only41110.404NANA 2774Carrier 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, Mechanical315603NANA 2775Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1234Wheelchair, Pediatric Size, Tilt-in-space, Folding, Adj, Wo Seating318803NANA 2776Carrier H2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement218402NANA 2777Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0005Ultralightweight Wheelchair250175.84025NANA 2778Carrier 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 Pr200156.35020NANA 2779Carrier 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, Width1801100.36018NANA 2780Carrier 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, Replacement9018009NANA 2781Carrier 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 Type800.59.657.626NANA 2782Carrier 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, Each5017605NANA 2783Carrier 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,50124100.814NANA 2784Carrier 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 Type1017201NANA 2785Carrier H2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0747Osteogenesis Stimulator (non-invasive)10112001NANA 2786Carrier 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 Extens1019601NANA 2787Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple290.97070.59128NANA 2788Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy550.9180.28055NANA 2789Carrier 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)440.9198.77044NANA 2790Carrier 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 C2350.8933.687.27233NANA 2791Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047Laminectomy W Facetectomy-lumbar290.87079.76128NANA 2792Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558Arthrod,interbdy Tech;lumbar,allogf530.822478.48251NANA 2793Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447Replacement Knee Total250.822483124NANA 2794Carrier 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, Lumbar430.774073.67241NANA 2795Carrier H2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22630Arthrodesis Post Interbody-lumbar100.793.82010NANA 2796Carrier 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)110.642486.77110NANA 2797Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75894Transcatheter Therapy Embolize Any Meth812451.4317NANA 2798Carrier 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 Approach712475.4316NANA 2799Carrier 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 Addtl61133.7106NANA 2800Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045Laminectomy W Facetectomy-cervical61247215NANA 2801Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134Revis.tot.hip Arthropl;both Compnts517205NANA 2802Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22802Arthrod,post,spin.deform,gft;7+vert415404NANA 2803Carrier 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 Segment41245613NANA 2804Carrier 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)317803NANA 2805Carrier 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 Interspac31248412NANA 2806Carrier H2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-lateral,ea Add.in3104812NANA 2807Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558Arthrod,interbdy Tech;lumbar,allogf53012478251NANA 2808Carrier 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)4401098.77044NANA 2809Carrier 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 C235013487233NANA 2810Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple2901070.59128NANA 2811Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047Laminectomy W Facetectomy-lumbar2901080128NANA 2812Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total25012483124NANA 2813Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22630Arthrodesis Post Interbody-lumbar1001093.82010NANA 2814Carrier 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; Lumbar901248718NANA 2815Carrier H2021Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970Intersex Op Male To Female70107607NANA 2816Carrier 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)5012419214NANA 2817Carrier H2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation130.462717.0967NANA 2818Carrier H2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric202523.1211NANA 2819Carrier H2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation130.462717.0967NANA 2820Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0399Home Sleep Test W/type Iii Portable Monitor38450.97303845NANA 2821Carrier 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 Performed70100.9503.3427008NANA 2822Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Brain; W/o Contrast & W/contrast & A35490.950643545NANA 2823Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Ct Abd & Pelvis W/o Contrast66730.940.185.09226651NANA 2824Carrier 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)29270.90.69491542773NANA 2825Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Magnetic Resonance Imaging, Any Jnt-lowe60520.890746048NANA 2826Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy Flexible, Transoral; With Biopsy, Single Or Multiple32840.890.59491863098NANA 2827Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri,spin.canal,cerv;w/o Contrst Mat23940.86010.332391NANA 2828Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri,spin.canal,lumb;w/o Cntrst Matl42760.851964270NANA 2829Carrier H2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity30780.850823076NANA 2830Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically Aided Anter,cruciate Li14211872.814138NANA 2831Carrier 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)801104.59080NANA 2832Carrier 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 Based63120063NANA 2833Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29874Arthroscop Knee W Remov Loose Body581873355NANA 2834Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29875Arthroscopy,knee,surg;synovec,limited-se5011074545NANA 2835Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78472Card Bld Pool Image; 1 Rest W/motn3410034NANA 2836Carrier 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 Time3210032NANA 2837Carrier 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; Complex41153911031NANA 2838Carrier H2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29876Arthroscopy, Knee, Surgical; With Lateral Release2718868028NANA 2839Carrier 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 Microfracture2812495127NANA 2840Carrier 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 Performed50101177423478NANA 2841Carrier 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; Simple3290140329NANA 2842Carrier 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 Performed137010731136NANA 2843Carrier 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.ca1190121778111NANA 2844Carrier 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)99011663396NANA 2845Carrier 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&morph53010053NANA 2846Carrier 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 Rep530170053NANA 2847Carrier 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/cntrs51010051NANA 2848Carrier 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;lumb49011977544NANA 2849Carrier 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 Lat340183034NANA 2850Carrier 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 MGMT1960.8224641153NANA 2851Carrier 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 MANAGEMENT1500.7924651149NANA 2852Carrier 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.2510.6924681171NANA 2853Carrier 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 MGMT1960.8224641153NANA 2854Carrier 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 MANAGEMENT1500.7924651149NANA 2855Carrier 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.2510.6924681171NANA 2856Carrier 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.25100.0524681171NANA 2857Carrier 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 MGMT19600.0924641153NANA 2858Carrier 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 MANAGEMENT15000.1324651149NANA 2859Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin110.9170.3548788611NANA 2860Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc100.0021925011NANA 2861Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl100.0020758321NANA 2862Carrier I2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.002136111NANA 2863Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin110.9170.3548788611NANA 2864Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc100.0021925011NANA 2865Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl100.0020758321NANA 2866Carrier I2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.002136111NANA 2867Carrier 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 Insulin1100.0970.3548788611NANA 2868Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1151.84393251NANA 2869Carrier 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]2390.982.043918472239NANA 2870Carrier 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)130.854.68177350413NANA 2871Carrier 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)30.679.3617592593NANA 2872Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor40.2596.940069444NANA 2873Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2624Adj skin pro/pos cus<22in100.0863583311NANA 2874Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi100.0864722211NANA 2875Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height100.0863130551NANA 2876Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in100.0864102771NANA 2877Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension100.0862741661NANA 2878Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2300Power wheelchair accessory, power seat elevation system2012.068752NANA 2879Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1026.893509171NANA 2880Carrier I2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab100.0708333341NANA 2881Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1151.84393251NANA 2882Carrier 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]2390.982.043918472239NANA 2883Carrier 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)130.854.68177350413NANA 2884Carrier 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)30.679.3617592593NANA 2885Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor40.2596.940069444NANA 2886Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2624Adj skin pro/pos cus<22in100.0863583311NANA 2887Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi100.0864722211NANA 2888Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height100.0863130551NANA 2889Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in100.0864102771NANA 2890Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension100.0862741661NANA 2891Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2300Power wheelchair accessory, power seat elevation system2012.068752NANA 2892Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal1026.893509171NANA 2893Carrier I2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab100.0708333341NANA 2894Carrier 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)213.6705434262NANA 2895Carrier 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)30.677.3848260283NANA 2896Carrier 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)30.677.3848260283NANA 2897Carrier 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; lumbar20.536.497463472NANA 2898Carrier 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)301.0912043523NANA 2899Carrier 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;300.0583891663NANA 2900Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT62141Cranioplasty for skull defect; larger than 5 cm diameter200.0819916672NANA 2901Carrier 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)200.0461218062NANA 2902Carrier 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);200.0029166672NANA 2903Carrier 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, supratentorial201.5933333342NANA 2904Carrier 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)202.859898612NANA 2905Carrier 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)300.0869444451.59333333412NANA 2906Carrier I2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15750Flap; neurovascular pedicle200.0872222210.00582777811NANA 2907Carrier 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)1124.151111111NANA 2908Carrier 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)213.6705434262NANA 2909Carrier 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; lumbar110.1066666671NANA 2910Carrier 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 allograft1119.344111111NANA 2911Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27446Arthroplasty, knee, condyle and plateau; medial OR lateral compartment1111.445151941NANA 2912Carrier 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 component1121.714321391NANA 2913Carrier 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 approach111.8211111131NANA 2914Carrier 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 approach111.8211111131NANA 2915Carrier 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 age1117.831NANA 2916Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible11240.52684721NANA 2917Carrier I2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk11240.52685081NANA 2918Carrier 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)112.7388888871NANA 2919Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder14143.0727314814NANA 2920Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric2121.580138892NANA 2921Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric1188.886666671NANA 2922Carrier I2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification110.20196751NANA 2923Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder14143.0727314814NANA 2924Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric2121.580138892NANA 2925Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric1188.886666671NANA 2926Carrier I2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification110.20196751NANA 2927Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1320.9414.74452149132NANA 2928Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2110.939.101342806211NANA 2929Carrier 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 saturation1560.936.463750842156NANA 2930Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis2230.8916.77075072223NANA 2931Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1400.850.2805555587.62105902867211391NANA 2932Carrier I2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr1480.8513.98278651148NANA 2933Carrier 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 flexibility2700.7430.39479178270NANA 2934Carrier 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 minutes2560.7233.19778745256NANA 2935Carrier 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 minutes1960.6828.1757568196NANA 2936Carrier 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 activities1390.6238.76119208139NANA 2937Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng3112.59238215531NANA 2938Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-2710.00016460927NANA 2939Carrier 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)24128.4717952324NANA 2940Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70491Contrast CAT scan of neck tissue1917.38042397719NANA 2941Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions1710.12427091517NANA 2942Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr14124.0380740714NANA 2943Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1112.04002314811NANA 2944Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl910.0001851859NANA 2945Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93308ECHO, transthoracic, heart, limited813.3559027788NANA 2946Carrier 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 joint7125.148726837NANA 2947Carrier 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 saturation7115.692222227NANA 2948Carrier 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 sleepiness710.0001190487NANA 2949Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70480CT, orbit, sella or pos fos wo contrast710.0818253977NANA 2950Carrier I2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction7113.323677567NANA 2951Carrier 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/brain20.573.522777782NANA 2952Carrier 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)60.1712.312168256NANA 2953Carrier 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 nerve130.1538.69889613NANA 2954Carrier 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 performed160.0623.8912591816NANA 2955Carrier I2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine1400.010.2805555587.62105902867211391NANA 2956Carrier 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 sequences1320.0114.74452149132NANA 2957Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services7119.332063497NANA 2958Carrier 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 management8162.7141666639.6011111117NANA 2959Carrier 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 session7162.7141666646.2003703716NANA 2960Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5135.119157785NANA 2961Carrier 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 management6162.7141666645.7702777815NANA 2962Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours110.9151.7862626311NANA 2963Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-60.8310.377777786NANA 2964Carrier 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; individual170.8234.6830542917NANA 2965Carrier 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 feeding90.5659.487226729NANA 2966Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete40.580.902685194NANA 2967Carrier I2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction40.580.902685194NANA 2968Carrier 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; complex110.0039027791NANA 2969Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services7119.332063497NANA 2970Carrier 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 management8162.7141666639.6011111117NANA 2971Carrier 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 session7162.7141666646.2003703716NANA 2972Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem5135.119157785NANA 2973Carrier 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 management6162.7141666645.7702777815NANA 2974Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences310.000370373NANA 2975Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue3163.600925933NANA 2976Carrier 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 approach2121.311388892NANA 2977Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes1145.008333341NANA 2978Carrier I2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant113.031388891NANA 2979Carrier 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)110.0752777781NANA 2980Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin910.9261.0668338291NANA 2981Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl8018.080447338NANA 2982Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM8017.181224568NANA 2983Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc8018.080489138NANA 2984Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys7020.04446257NANA 2985Carrier 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 ADD2010.041666672NANA 2986Carrier 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 system100.0941666671NANA 2987Carrier J2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274Ext amb insuline delivery sys100.0048241661NANA 2988Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin910.9261.0668338291NANA 2989Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl8018.080447338NANA 2990Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277External transmitter, CGM8017.181224568NANA 2991Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc8018.080489138NANA 2992Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276Disposable sensor, CGM sys7020.04446257NANA 2993Carrier 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 ADD2010.041666672NANA 2994Carrier 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 system100.0941666671NANA 2995Carrier J2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274Ext amb insuline delivery sys100.0048241661NANA 2996Carrier 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)1760.9746.347777781.6665984131175NANA 2997Carrier 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]34830.9646.347777782.304491152612134822NANA 2998Carrier 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)740.8633.6302777810.69826984470NANA 2999Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal80.38136.73588958NANA 3000Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER70.2933.63027778111.890370443NANA 3001Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi200.2571.13215972122.0365107218NANA 3002Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor250.2110.539243625NANA 3003Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine190.16130.546169819NANA 3004Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi7040.980903177NANA 3005Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B6047.796694636NANA 3006Carrier J2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height6030.691410326NANA 3007Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device1146.3477777857611NANA 3008Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0561Humidifier, non-heated, used with positive airway pressure device1146.347777781NANA 3009Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified41140.61145834NANA 3010Carrier 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)1760.9746.347777781.6665984131175NANA 3011Carrier 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]34830.9646.347777782.304491152612134822NANA 3012Carrier 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)740.8633.6302777810.69826984470NANA 3013Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal80.38136.73588958NANA 3014Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER70.2933.63027778111.890370443NANA 3015Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi200.2571.13215972122.0365107218NANA 3016Carrier J2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor250.2110.539243625NANA 3017Carrier 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]34830046.347777782.304491152612134822NANA 3018Carrier 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)440.9346.5221863244NANA 3019Carrier 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)210.939.5050889421NANA 3020Carrier 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; lumbar200.941.6077904320NANA 3021Carrier 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; lumbar250.8857.31271103480251NANA 3022Carrier 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)320.8847.1175347732NANA 3023Carrier 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);330.211.42881083432.52842918429NANA 3024Carrier 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)240.080.0027777778.561956111123NANA 3025Carrier J2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis280.070.00678333216.29482006226NANA 3026Carrier 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 pump2000.0055555566.504863889119NANA 3027Carrier 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 valve21016.8506751422.84802685615NANA 3028Carrier 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); lumbar19148.3796979719NANA 3029Carrier 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 allograft12170.437058712NANA 3030Carrier 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))11138.0734598911NANA 3031Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion7155.48255267NANA 3032Carrier 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)5152.860691825NANA 3033Carrier 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)5119.049772325NANA 3034Carrier 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; lumbar4172.864977194NANA 3035Carrier 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)4115.812225864NANA 3036Carrier 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)4150.717728134NANA 3037Carrier 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; lumbar3124.990004223NANA 3038Carrier 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)3117.875292923NANA 3039Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43279Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed31121.18768523NANA 3040Carrier 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)3154.816303833NANA 3041Carrier J2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23470Arthroplasty, glenohumeral joint; hemiarthroplasty318.0435268523NANA 3042Carrier 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 segments3141.491192433NANA 3043Carrier 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; cervical315.1079698330.38467861121NANA 3044Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNARoom and board, Semi Private Detoxification4146.050347224NANA 3045Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state31128.31685193NANA 3046Carrier 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 approach31128.31685193NANA 3047Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete2126.241388892NANA 3048Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra2126.16163582NANA 3049Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57110Vaginectomy, complete removal of vaginal wall;1171.766388891NANA 3050Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56800Plastic repair of introitus11332.46777781NANA 3051Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57292Construction of artificial vagina; with graft11332.46777781NANA 3052Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57291Construction of artificial vagina; without graft1126.959166671NANA 3053Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra1171.766388891NANA 3054Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNAAlcohol and/or other drug treatment program, per diem1118.84751NANA 3055Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55180Scrotoplasty; complicated1171.766388891NANA 3056Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNARoom and board, Semi-Private, Psychiatric320.948.061203704269.5459427329NANA 3057Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAResidential treatment, Substance Use Disorder2380.9350.64727495238NANA 3058Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAResidential treatment, Psychiatric470.7228.53694444241.0093836344NANA 3059Carrier 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 cm20.570.939782112NANA 3060Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNACrisis Intervention Mental H100.0053619431NANA 3061Carrier 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 children1048.621399171NANA 3062Carrier 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)1048.621399171NANA 3063Carrier 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 less1048.621399171NANA 3064Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCNAAlcohol And/Or Drug Services100.0032269441NANA 3065Carrier 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 children1048.621399171NANA 3066Carrier 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)1048.621399171NANA 3067Carrier 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 children1048.621399171NANA 3068Carrier 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 nerve1048.621399171NANA 3069Carrier 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 feet1048.621399171NANA 3070Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15750Flap; neurovascular pedicle1048.621399171NANA 3071Carrier 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)1048.621399171NANA 3072Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15757Free skin flap with microvascular anastomosis1048.621399171NANA 3073Carrier 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 cm1048.621399171NANA 3074Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT29125Application of short arm splint (forearm to hand); static1048.621399171NANA 3075Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT31587Laryngoplasty, cricoid split, without graft placement10246.251NANA 3076Carrier 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 transposition1048.621399171NANA 3077Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT51102Aspiration of bladder; with insertion of suprapubic catheter1048.621399171NANA 3078Carrier 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)1048.621399171NANA 3079Carrier 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 centimeters1048.621399171NANA 3080Carrier 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)1048.621399171NANA 3081Carrier 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 less1048.621399171NANA 3082Carrier 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)1048.621399171NANA 3083Carrier 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 cm1048.621399171NANA 3084Carrier 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)1048.621399171NANA 3085Carrier 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)1048.621399171NANA 3086Carrier J2021Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970Intersex surgery; male to female10261.61NANA 3087Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification4146.050347224NANA 3088Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state31128.31685193NANA 3089Carrier 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 approach31128.31685193NANA 3090Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete2126.241388892NANA 3091Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra2126.16163582NANA 3092Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57110Vaginectomy, complete removal of vaginal wall;1171.766388891NANA 3093Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56800Plastic repair of introitus11332.46777781NANA 3094Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57292Construction of artificial vagina; with graft11332.46777781NANA 3095Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57291Construction of artificial vagina; without graft1126.959166671NANA 3096Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra1171.766388891NANA 3097Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem1118.84751NANA 3098Carrier J2021Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55180Scrotoplasty; complicated1171.766388891NANA 3099Carrier J2021Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue1001Residential treatment, Psychiatric4700.0228.53694444241.0093836344NANA 3100Carrier 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 saturation17170.964.551587741717NANA 3101Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences15350.950.08759.11342266431532NANA 3102Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete27820.940.0872222216.2601454696601278110NANA 3103Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis30240.943.5201149439.638329536292995NANA 3104Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr25110.880.23972222211.00589676648125105NANA 3105Carrier J2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine18450.861.0481944448.480348817672218432NANA 3106Carrier 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 flexibility55250.749.45408001339.65143342610.519550616NANA 3107Carrier 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 minutes50400.7317.552093642.139664875911950218NANA 3108Carrier 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 minutes46570.7324.9135211639.53006852810.66666671246459NANA 3109Carrier 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 activities36790.7148.7211516743.901583385681136683NANA 3110Carrier 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 coupling23131.10083644600231NANA 3111Carrier 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 fractions18111.7404629659.415407416003151NANA 3112Carrier 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))31131.758682537.73359205130NANA 3113Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72147Contrast MRI of thoracic spine2912.43074712729NANA 3114Carrier 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; lumbar30151.4807861132.48858983228NANA 3115Carrier 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)2513.86894268325NANA 3116Carrier J2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78472Nuclear scan, cardiac blood pool2210.00011363622NANA 3117Carrier 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)22160.9581296522NANA 3118Carrier 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 fractions17111.7404629660.40331349314NANA 3119Carrier 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)1311.97444444486.46290404211NANA 3120Carrier 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 nerve9300.040.22140416754.877798546482911NANA 3121Carrier 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 level30900.0323.4483643115.212168182307NANA 3122Carrier 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 level15300.0214.66959782153NANA 3123Carrier 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, cervical4000.0342.6052056540NANA 3124Carrier 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)2100.0515.3693431821NANA 3125Carrier 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 STUDY800.1328.070486118NANA 3126Carrier 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, cervical700.1446.311051767NANA 3127Carrier 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, epidural500.275.656156875NANA 3128Carrier J2021Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23470Arthroplasty, glenohumeral joint; hemiarthroplasty500.280.849107555NANA 3129Carrier 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; lumbar400.2544.091728754NANA 3130Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services18717.52954805532.137499779178NANA 3131Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem990.9743.7772355899NANA 3132Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete350.9483.99884921696351NANA 3133Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction340.94243.657777885.11815657133NANA 3134Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours1150.9154.6793055662.029265652113NANA 3135Carrier 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 session780.925.8108971247.675709085529691NANA 3136Carrier J2021Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-1980.93.088960078198NANA 3137Carrier 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 management520.922.3572951244.10535269745NANA 3138Carrier 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 management820.8925.8108966344.54946906973NANA 3139Carrier 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; individual2820.73314.702052867.410744061281NANA 3140Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services18717.52954805532.137499779178NANA 3141Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1210.02682870412NANA 3142Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes71268.13452387NANA 3143Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue51103.43916675NANA 3144Carrier 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) alleles4126.465138894NANA 3145Carrier 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 abnormalities4125.550069444NANA 3146Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions417.3549659724NANA 3147Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant3188.21370373NANA 3148Carrier 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 technologist410.289444445013NANA 3149Carrier 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 fractions2132.127638892NANA 3150Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56625Vulvectomy simple; complete2181.962222222NANA 3151Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78608Brain imaging, PET, metabolic eval2113.578888892NANA 3152Carrier 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 analysis2117.923472222NANA 3153Carrier 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)2117.923472222NANA 3154Carrier 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 approach21119.018752NANA 3155Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple21119.018752NANA 3156Carrier J2021Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ3014Telehealth originating site facility fee2150.492760142NANA 3157Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin617.03060NANA 3158Carrier 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 accessories1123.5010NANA 3159Carrier K2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1123.5010NANA 3160Carrier 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�20.585.5020NANA 3161Carrier 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 system20.585.5020NANA 3162Carrier K2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin617.03060NANA 3163Carrier 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 accessories1123.5010NANA 3164Carrier K2021Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1123.5010NANA 3165Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications�3140.5030NANA 3166Carrier 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 minutes2184.9020NANA 3167Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5301Below knee, molded socket, shin, sach foot, endoskeletal system21104.7020NANA 3168Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5620Addition to lower extremity, test socket, below knee21104.7020NANA 3169Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5629Addition to lower extremity, below knee, acrylic socket21104.7020NANA 3170Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5637Addition to lower extremity, below knee, total contact21104.7020NANA 3171Carrier 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�21104.7020NANA 3172Carrier 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 insert21104.7020NANA 3173Carrier 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 mechanism21104.7020NANA 3174Carrier K2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous30140.8030NANA 3175Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications�3140.5030NANA 3176Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5301Below knee, molded socket, shin, sach foot, endoskeletal system21104.7020NANA 3177Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620Addition to lower extremity, test socket, below knee21104.7020NANA 3178Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5629Addition to lower extremity, below knee, acrylic socket21104.7020NANA 3179Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637Addition to lower extremity, below knee, total contact21104.7020NANA 3180Carrier 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�21104.7020NANA 3181Carrier 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 insert21104.7020NANA 3182Carrier 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 mechanism21104.7020NANA 3183Carrier K2021DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910Addition, endoskeletal system, below knee, alignable system21104.7020NANA 3184Carrier 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)21104.7020NANA 3185Carrier K2021DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399Durable medical equipment, miscellaneous101325.44010NANA 3186Carrier 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)3137.3030NANA 3187Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11970Replacement of tissue expander with permanent implant2122020NANA 3188Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11971Removal of tissue expander without insertion of implant2156020NANA 3189Carrier 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)2122020NANA 3190Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49999Unlisted procedure, abdomen, peritoneum and omentum�21115020NANA 3191Carrier 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)20.5108.8020NANA 3192Carrier 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 less20.5108.8020NANA 3193Carrier 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)20.5108.8020NANA 3194Carrier 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)20.5118.3020NANA 3195Carrier K2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra20.5108.5020NANA 3196Carrier 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)3137.3030NANA 3197Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11970Replacement of tissue expander with permanent implant2122020NANA 3198Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11971Removal of tissue expander without insertion of implant2156020NANA 3199Carrier K2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19380Unlisted procedure, abdomen, peritoneum and omentum�2122020NANA 3200Carrier 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)21115020NANA 3201Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5519.73.664510NANA 3202Carrier 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)53112.93.83500NANA 3203Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure�530.9610.280530NANA 3204Carrier 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 21350.949.80350NANA 3205Carrier 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)�1260.910.215.111250NANA 3206Carrier 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�850.910.215.111840NANA 3207Carrier 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 forceps650.910.216.41640NANA 3208Carrier K2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1110.925.117.0121090NANA 3209Carrier 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 technologist290.5948.936.82270NANA 3210Carrier 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 technologist360.542.352.91340NANA 3211Carrier K2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5519.73.664510NANA 3212Carrier 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)53112.93.83500NANA 3213Carrier 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)�2011.30200NANA 3214Carrier 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 wire1110.20110NANA 3215Carrier 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�1010.170100NANA 3216Carrier 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)�1010.120100NANA 3217Carrier 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�915.7090NANA 3218Carrier 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)13111.32.1580NANA 3219Carrier 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 variant714.2070NANA 3220Carrier 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�712545.6160NANA 3221Carrier 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 accessory41117.2040NANA 3222Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable20.5106.8020NANA 3223Carrier 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)�20.546.4020NANA 3224Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous40100040NANA 3225Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9999Miscellaneous dme supply or accessory, not otherwise specified30139.4030NANA 3226Carrier 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 adjustment20124.7020NANA 3227Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930SP BONE ALGRFT MORSEL ADD-ON61290600NANA 3228Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936SP BONE AGRFT LOCAL ADD-ON61290600NANA 3229Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22556ARTHRD ANT NTRBD MIN DSC THC61290600NANA 3230Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22610ARTHRD PST TQ 1NTRSPC THRC61290600NANA 3231Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840INSERT SPINE FIXATION DEVICE61290600NANA 3232Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMECHANICAL DEVICE61290600NANA 3233Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63064DECOMPRESS SPINAL CORD THRC61290600NANA 3234Carrier 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)40.7519.347.313NANA 3235Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk2141.42NANA 3236Carrier L2021Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible2141.42NANA 3237Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20930SP BONE ALGRFT MORSEL ADD-ON61290600NANA 3238Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20936SP BONE AGRFT LOCAL ADD-ON61290600NANA 3239Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22556ARTHRD ANT NTRBD MIN DSC THC61290600NANA 3240Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22610ARTHRD PST TQ 1NTRSPC THRC61290600NANA 3241Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840INSERT SPINE FIXATION DEVICE61290600NANA 3242Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853INSJ BIOMECHANICAL DEVICE61290600NANA 3243Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63064DECOMPRESS SPINAL CORD THRC61290600NANA 3244Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk2141.42NANA 3245Carrier L2021Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible2141.42NANA 3246Carrier 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 infection2141.42NANA 3247Carrier 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)1920.840.216.161860NANA 3248Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1850.836.717.971780NANA 3249Carrier 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 technique1380.80411.619.641340NANA 3250Carrier 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 forceps860.8119.20860NANA 3251Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure740.939.70740NANA 3252Carrier L2021Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple660.980.44.27590NANA 3253Carrier 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)640.980.24.46580NANA 3254Carrier 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 technologist620.6122.843.21610NANA 3255Carrier 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 technologist490.634847.41480NANA 3256Carrier 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 21270.967.70270NANA 3257Carrier 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)110346.08010NANA 3258Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple110684.48010NANA 3259Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure110344.88010NANA 3260Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29827SHO ARTHRS SRG RT8TR CUF RPR0NANA 3261Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29822SHO ARTHRS SRG LMTD DBRDMT0NANA 3262Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT25390SHORTEN RADIUS OR ULNA0NANA 3263Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27279ARTHRODESIS SACROILIAC JOINT0NANA 3264Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY0NANA 3265Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29828SHO ARTHRS SRG BICP TENODSIS0NANA 3266Carrier L2021Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29846WRIST ARTHROSCOPY/SURGERY0NANA 3267Carrier L2021Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin9113.716.4180NANA 3268Carrier 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 Service110.1010NANA 3269Carrier 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 accessory41117.2040NANA 3270Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous40100040NANA 3271Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9999Miscellaneous dme supply or accessory, not otherwise specified30139.4030NANA 3272Carrier 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 adjustment20124.7020NANA 3273Carrier L2021DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable20.5106.8020NANA 3274Carrier 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)�20.546.4020NANA 3275Carrier 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)120.5167012NANA 3276Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST12121.2012NANA 3277Carrier 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 CM110.545570.353.1110NANA 3278Carrier 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)100.857.4010NANA 3279Carrier 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);10192.411.219NANA 3280Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG100.863.488.519NANA 3281Carrier 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, INTERPRE100.644.2010NANA 3282Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY8117.108NANA 3283Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT80.62545.508NANA 3284Carrier M2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION70.714314907NANA 3285Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST12121.2012NANA 3286Carrier 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);10192.411.219NANA 3287Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY8117.108NANA 3288Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY, SURGICAL;COLECTOMY, PARTIAL, WITH ANASTOMOSIS716.207NANA 3289Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9208INJECTION, IFOSFAMIDE, 1 GRAM71102.307NANA 3290Carrier 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)71100.707NANA 3291Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP6150.806NANA 3292Carrier 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)6120.706NANA 3293Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT516.53.314NANA 3294Carrier M2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9181INJECTION, ETOPOSIDE, 10 MG51124.105NANA 3295Carrier 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 CM1100.5570.353.1110NANA 3296Carrier 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; LUMBAR600.3363.463.815NANA 3297Carrier 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)1000.857.4010NANA 3298Carrier 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 SEG1000.863.488.519NANA 3299Carrier 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)1200.5167012NANA 3300Carrier 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 (LIS10025.301NANA 3301Carrier 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 PRO400.591.904NANA 3302Carrier 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 DEVICE1002401NANA 3303Carrier 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/ALGRFT800.6345.508NANA 3304Carrier 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)200.5273.702NANA 3305Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585Botox1410.8926422139NANA 3306Carrier 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 CYCLOPHOTOCOAGULATION981427.4197NANA 3307Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSTD EMBRYO HATCHING MICROTQS ANY METH940.57107.8094NANA 3308Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89258CRYOPRSRV EMBRYO890.7594.4089NANA 3309Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89342STORAGE, (PER YEAR); EMBRYO(S)810.7881.3081NANA 3310Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318BREAST REDUCTION810.769.5081NANA 3311Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS4022ASST OOCYTE FERT CASE RATE730.4291.5073NANA 3312Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS4016FROZEN IVF CASE RATE660.8955.8066NANA 3313Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT620.982414.3062NANA 3314Carrier M2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS4011IVF PACKAGE610.6798061NANA 3315Carrier 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 CYCLOPHOTOCOAGULATION981427.4197NANA 3316Carrier 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 TREATED52155.4052NANA 3317Carrier 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 & C33119.178.8132NANA 3318Carrier 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 TREATED16151.8016NANA 3319Carrier 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 ROUTIN15110.8015NANA 3320Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19380REVJ RECONSTRUCTED BREAST13124.1013NANA 3321Carrier 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)1317.8013NANA 3322Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15823BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID12124.9012NANA 3323Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36471NJX SCLEROSING SOLUTION MULTIPLE VEINS SAME LEG11154.4011NANA 3324Carrier M2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99354PROLNG SVC O/P 1ST HOUR10133.961.628NANA 3325Carrier 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 COMPARTMENTS6100.6738.1061NANA 3326Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89258CRYOPRSRV EMBRYO8900.7594.4089NANA 3327Carrier 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/ALGRFT5400.7639.3054NANA 3328Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS4011IVF PACKAGE6100.6798061NANA 3329Carrier 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)8100.7881.3081NANA 3330Carrier 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 SINUS3000.531.960.6129NANA 3331Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19318BREAST REDUCTION8100.769.5081NANA 3332Carrier 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 EXPLORATION2700.599.779.2225NANA 3333Carrier M2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS4015COMPLETE IVF NOS CASE RATE2600.73205.6026NANA 3334Carrier 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 METH9400.57107.8094NANA 3335Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY470.9126.8249.3443NANA 3336Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY7111.424.443NANA 3337Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH INPATIENT219602NANA 3338Carrier M2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearInternalNADETOXIFICATION110.101NANA 3339Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY7111.424.443NANA 3340Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH INPATIENT219602NANA 3341Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNADETOXIFICATION110.101NANA 3342Carrier M2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearInternalNAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY470.9126.8249.3443NANA 3343Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNAMENTAL HEALTH INPATIENT2019602NANA 3344Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY70111.424.443NANA 3345Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNADETOXIFICATION1010.101NANA 3346Carrier M2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealInternalNAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY4700.9126.8249.3443NANA 3347Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MH PARTIAL HOSP TX UNDER 24H930.989.8328.8291NANA 3348Carrier 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) A750.99491.7075NANA 3349Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN660.88803.1066NANA 3350Carrier 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 MINUTES650.92740.1065NANA 3351Carrier 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 MINUTES600.98636.2060NANA 3352Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM460.8781.2109.1244NANA 3353Carrier M2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT420.93730.4042NANA 3354Carrier 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 SESSION380.61239.9038NANA 3355Carrier 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 MANAGEMENT350.57204035NANA 3356Carrier 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 MANAGEMENT180.56285.2018NANA 3357Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY, 30 MINUTES WITH PATIENT5110.905NANA 3358Carrier 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 OF21127.402NANA 3359Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96131PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR2122.802NANA 3360Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT21176.602NANA 3361Carrier 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 MIN2122.802NANA 3362Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR2122.802NANA 3363Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90846FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT212.102NANA 3364Carrier 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 MIN2122.802NANA 3365Carrier M2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90839PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES1123.201NANA 3366Carrier 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)112401NANA 3367Carrier 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 SESSION3800.61239.9038NANA 3368Carrier 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 MANAGEMENT3500.57204035NANA 3369Carrier 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 T100115.601NANA 3370Carrier 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 MIN200.558.602NANA 3371Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90832PSYCHOTHERAPY, 30 MINUTES WITH PATIENT50110.905NANA 3372Carrier 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 MIN300.671527.703NANA 3373Carrier M2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION1400.86124.3014NANA 3374Carrier 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) A7500.99491.7075NANA 3375Carrier 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 HOUR20122.802NANA 3376Carrier 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 MIN300.331527.703NANA 3377Carrier 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 ADJUSTMENT2059.702NANA 3378Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5652SUCTION SUSP AK/KNEE DISART1128.301NANA 3379Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5649ISCH CONTAINMT/NARROW M-L SO1128.201NANA 3380Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5845KNEE-SHIN SYS STANCE FLEXION1128.301NANA 3381Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8480PROS SOCK SINGLE PLY AK1128.201NANA 3382Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5981FLEX-WALK SYS LOW EXT PROSTH112201NANA 3383Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8460SHRINKER ABOVE KNEE1128.201NANA 3384Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5950ENDO AK ULTRA-LIGHT MATERIAL1128.201NANA 3385Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5650TOT CONTACT AK/KNEE DISART S1128.201NANA 3386Carrier M2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.201NANA 3387Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5652SUCTION SUSP AK/KNEE DISART1128.301NANA 3388Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8480PROS SOCK SINGLE PLY AK1128.201NANA 3389Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5649ISCH CONTAINMT/NARROW M-L SO1128.201NANA 3390Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5845KNEE-SHIN SYS STANCE FLEXION1128.301NANA 3391Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5968MULTIAXIAL ANKLE W DORSIFLEX1121.901NANA 3392Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5981FLEX-WALK SYS LOW EXT PROSTH112201NANA 3393Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8460SHRINKER ABOVE KNEE1128.201NANA 3394Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5950ENDO AK ULTRA-LIGHT MATERIAL1128.201NANA 3395Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5650TOT CONTACT AK/KNEE DISART S1128.201NANA 3396Carrier M2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.201NANA 3397Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5652SUCTION SUSP AK/KNEE DISART10128.301NANA 3398Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5649ISCH CONTAINMT/NARROW M-L SO10128.201NANA 3399Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5845KNEE-SHIN SYS STANCE FLEXION10128.301NANA 3400Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8480PROS SOCK SINGLE PLY AK10128.201NANA 3401Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5981FLEX-WALK SYS LOW EXT PROSTH1012201NANA 3402Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8460SHRINKER ABOVE KNEE10128.201NANA 3403Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5950ENDO AK ULTRA-LIGHT MATERIAL10128.201NANA 3404Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5650TOT CONTACT AK/KNEE DISART S10128.201NANA 3405Carrier M2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5920ENDO AK/HIP ALIGNABLE SYSTEM10128.201NANA 3406Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3730.5634.7412.9592281OZEMPIC/RYBELSUSNA 3407Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2420.7564.139.5665177DEPO-TESTOSTERONE/TESTOSTERONENA 3408Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1970.89810.169.4630167FIRST-OMEPRAZOLE/OMEPRAZOLE/PRILOSECNA 3409Carrier 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/MYDAYISNA 3410Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1470.7143.1210.519128PROTOPIC/TACROLIMUSNA 3411Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1460.873.7812.455294HYDROCODONE/HYDROCODONE-ACETAMINOPHEN/HYDROCODONE-APAP/HYDROCODONE/ACETAMINOPHENNA 3412Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1320.9320.536.926106PANTOPRAZOLENA 3413Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1210.7777.8916.152794DULAGLUTIDE/TRULICITYNA 3414Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1210.8767.9540.742596HUMIRANA 3415Carrier M2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1150.8170.297.442590ABSORICA/ACCUTANE/AMNESTEEM/CLARAVIS/ISOTRETINOIN/MYORISAN/ZENATANENA 3416Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2517.7418.09916SKYRIZINA 3417Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2211.7718.81616GABAPENTINNA 3418Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2018.3815.88614OMEPRAZOLE/PANTOPRAZOLE/RABEPRAZOLENA 3419Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1415.342.62410JANUMETNA 3420Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA141016.31113AKLIEFNA 3421Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9116.8609HIZENTRANA 3422Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA912.660.0481CAPECITABINENA 3423Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA710025ZALEPLONNA 3424Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7100.0143RAMELTEONNA 3425Carrier M2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA610.9219.0215PROLIANA 3426Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50141.3705STELARANA 3427Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30160.1803ANDROGEL/TESTOSTERONENA 3428Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3010.7142.4312HUMIRANA 3429Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3012.230ELIQUISNA 3430Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20152.622.7211TESTOSTERONENA 3431Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20113.8520WEGOVYNA 3432Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2010.5420ARMODAFINILNA 3433Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2015.085.1811GRALISENA 3434Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20135.6102SIMPONINA 3435Carrier M2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2010.2619.7511COSENTYXNA 3436Carrier 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/GYN1400.7195331109NANA 3437Carrier 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)170.94122670215NANA 3438Carrier 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)140.92861671212NANA 3439Carrier 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)111266529NANA 3440Carrier 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)110.90912969110NANA 3441Carrier 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);91175736NANA 3442Carrier 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)90.7778197336NANA 3443Carrier F2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue760Ancillary Services - Specialty Services-General Classification70.857112616NANA 3444Carrier 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)60.83336706NANA 3445Carrier 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)61175224NANA 3446Carrier 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)111266529NANA 3447Carrier 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);91175736NANA 3448Carrier 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)61175224NANA 3449Carrier 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)613206NANA 3450Carrier 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 performed61143115NANA 3451Carrier 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)518005NANA 3452Carrier 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); lumbar515705NANA 3453Carrier 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)51134123NANA 3454Carrier 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 segment41174522NANA 3455Carrier 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)41144913NANA 3456Carrier 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/GYN14000.0071195331109NANA 3457Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5050.9267144872433NANA 3458Carrier 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)4310.9188164969362NANA 3459Carrier 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 cyclophotocoagulation1320.9394216111121NANA 3460Carrier 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 level1310.9389164614117NANA 3461Carrier 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)1160.663813408108NANA 3462Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1040.69231736797NANA 3463Carrier 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.1020.362729763171NANA 3464Carrier F2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92250Fundus photography with interpretation and report910.96710702071NANA 3465Carrier 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 allograft910.87913273784NANA 3466Carrier 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)830.91572267380NANA 3467Carrier 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 performed5011837545NANA 3468Carrier 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)1411480212NANA 3469Carrier 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 performed1311565310NANA 3470Carrier 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 performed12181012NANA 3471Carrier 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 arthrography10189010NANA 3472Carrier 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)915909NANA 3473Carrier 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)81249817NANA 3474Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31287Nasal/sinus endoscopy, surgical, with sphenoidotomy;715907NANA 3475Carrier 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)71257525NANA 3476Carrier F2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63650Percutaneous implantation of neurostimulator electrode array, epidural718307NANA 3477Carrier 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 performed1014310NANA 3478Carrier 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 cerclage1014310NANA 3479Carrier 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 resection1015201NANA 3480Carrier 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 nerve200.57402NANA 3481Carrier 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;200.52411911NANA 3482Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15877Suction assisted lipectomy; trunk400.259704NANA 3483Carrier 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.900.22222010072NANA 3484Carrier 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)700.14298507NANA 3485Carrier F2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350Nipple/areola reconstruction1400.0714101014NANA 3486Carrier 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.2200.04552985913NANA 3487Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation100.7296837NANA 3488Carrier 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 diem40.75148322NANA 3489Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric20.56911211NANA 3490Carrier F2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0046Mental health services, not otherwise specified116910NANA 3491Carrier 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 diem112401NANA 3492Carrier 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)112601NANA 3493Carrier 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)112601NANA 3494Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0046Mental health services, not otherwise specified116910NANA 3495Carrier 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 diem112401NANA 3496Carrier 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 diem40.75148322NANA 3497Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation100.7296837NANA 3498Carrier F2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric20.56911211NANA 3499Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1430.8741275116127NANA 3500Carrier 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 education560.69642360353NANA 3501Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem410.82931851635NANA 3502Carrier 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 plan320.81252379230NANA 3503Carrier 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 session300.71865723NANA 3504Carrier 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 minutes300.83332376228NANA 3505Carrier 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 management270.62961559522NANA 3506Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem250.762649619NANA 3507Carrier F2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2019Therapeutic behavioral services, per 15 minutes240.75073123NANA 3508Carrier 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 minutes230.869676023NANA 3509Carrier 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 hour414604NANA 3510Carrier 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)314303NANA 3511Carrier 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.2110302NANA 3512Carrier 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)215402NANA 3513Carrier 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 minutes215102NANA 3514Carrier F2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2012Behavioral health day treatment, per hour212202NANA 3515Carrier 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)111901NANA 3516Carrier 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 hour117401NANA 3517Carrier 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 minutes117401NANA 3518Carrier 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)117401NANA 3519Carrier 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 supply390.666793039NANA 3520Carrier 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)290.793191029NANA 3521Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous positive airway pressure (CPAP) device220.409174022NANA 3522Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each150.866713102213NANA 3523Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable150.933313102213NANA 3524Carrier 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 accessories140.928613100212NANA 3525Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair component or accessory, not otherwise specified90.55565409NANA 3526Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin90.88894809NANA 3527Carrier F2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7035Headgear used with positive airway pressure device80.1257108NANA 3528Carrier 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-shelf80.875215017NANA 3529Carrier 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 diem7119316NANA 3530Carrier 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 section619006NANA 3531Carrier 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 tests519805NANA 3532Carrier 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 adjustment514.35214NANA 3533Carrier 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 shelf519005NANA 3534Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCV2624Polishing/resurfacing of ocular prosthesis518705NANA 3535Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1392Portable oxygen concentrator, rental41137022NANA 3536Carrier 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 only418204NANA 3537Carrier 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 unit318203NANA 3538Carrier F2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications319703NANA 3539Carrier 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 adjustment200.514202NANA 3540Carrier 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 size200.57302NANA 3541Carrier 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 unit300.33338203NANA 3542Carrier 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 leg400.25011222NANA 3543Carrier 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 pressure400.25011222NANA 3544Carrier 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 diem700.142919316NANA 3545Carrier F2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips230.60869.224320NANA 3546Carrier F2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips230.60869.224320NANA 3547Carrier 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/GYN1090.6716.448.71891NANA 3548Carrier 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 Gastroent610.752440.1160NANA 3549Carrier 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), With490.6928.845.2742NANA 3550Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy470.9447.5047NANA 3551Carrier 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 Int420.861266.2240NANA 3552Carrier 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 & Decom210.8650.5021NANA 3553Carrier 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 Techn1412454.5113NANA 3554Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19328Removal Of Intact Breast Implant140.0724014NANA 3555Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-Lateral,Ea Add.In140.6464.8014NANA 3556Carrier H2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim140.43068113NANA 3557Carrier 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 Techn1412454.5113NANA 3558Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple131040112NANA 3559Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75894Transcatheter Therapy Embolize Any Meth7104843NANA 3560Carrier 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,614006NANA 3561Carrier 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 Fem5128.805NANA 3562Carrier 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 Techni5124014NANA 3563Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT42950Pharyngoplasty415404NANA 3564Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22632Arthrodesis, Each Additional Interspace415404NANA 3565Carrier H2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50365Renal Homotxplnt,Implnt Gft;W/Recipnt Ne31803NANA 3566Carrier 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 Gastroent61012440.1160NANA 3567Carrier 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 Gastrectomy470147.5047NANA 3568Carrier 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 Techn14012454.5113NANA 3569Carrier 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 Specim1401068113NANA 3570Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43659Unlisted Laparoscopy Procedure, Stomach1101037.729NANA 3571Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total100145.3010NANA 3572Carrier 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 & Ile50133.605NANA 3573Carrier H2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22632Arthrodesis, Each Additional Interspace4015404NANA 3574Carrier 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/ Magnet2013602NANA 3575Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echo, Transthoracic W/Doppler, Complete320930.972.43.82032073NANA 3576Carrier 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]271680.971.7027168NANA 3577Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Mri, Lower Extremity Any Joint; Wo Contr251610.931.94.96325098NANA 3578Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176Ct Abd & Pelvis240030.962.14.517423829NANA 3579Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTMSMPTPhysical Therapy210690.69411NANA 3580Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri Of Lumbar Spine182390.936.35.62318216NANA 3581Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Of Brain And Further Sequences155470.971.73.62815519NANA 3582Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity; Wo Co123030.9245.81812285NANA 3583Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri Of Cervical Spine106910.932.45.91010681NANA 3584Carrier H2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551Mri Of Brain95090.962.55199490NANA 3585Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74712Mri Fetal Sngl/1St Gestation10710.70107NANA 3586Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70545Mra, Head, W/Contrast1011123.2299NANA 3587Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ0585Injection, Onabotulinumtoxin A, 1 Unit4910049NANA 3588Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74261Ct Colonography, Diag, W/O Dye4111.8041NANA 3589Carrier 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 Spinal3410034NANA 3590Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73206Cta Upr Extrm W/Wo Contrast3113.9031NANA 3591Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72191Cta, Pelvis W/O Cntrst Flwd Cntrst2710027NANA 3592Carrier H2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81340Trb@ Gene Rearrange Amplify2413024NANA 3593Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total229014.834.95224NANA 3594Carrier H2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple19101032.56185NANA 3595Carrier 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, Ar710135071NANA 3596Carrier 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 Less69012443366NANA 3597Carrier 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, Ar420131.8042NANA 3598Carrier 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 D410138041NANA 3599Carrier 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, Osteophytec3801072236NANA 3600Carrier 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 Gastroent330132033NANA 3601Carrier 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 & Im32013.439.3725NANA 3602Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation110.1820.763.456NANA 3603Carrier 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 diem20.524.202NANA 3604Carrier 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 education1065.401NANA 3605Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric1041.710NANA 3606Carrier H2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification1065.401NANA 3607Carrier 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 Inpat10001NANA 3608Carrier 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)10001NANA 3609Carrier 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 Inpatien10001NANA 3610Carrier 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 diem20.524.202NANA 3611Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation110.1820.763.456NANA 3612Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric1041.710NANA 3613Carrier H2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification1065.401NANA 3614Carrier 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 education1065.401NANA 3615Carrier 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 Inpat10001NANA 3616Carrier 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)10001NANA 3617Carrier 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 Inpatien10001NANA 3618Carrier 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 diem200.524.202NANA 3619Carrier 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)-Rehabilitation1100.1820.763.456NANA 3620Carrier 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)-Psychiatric10041.710NANA 3621Carrier 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)-Detoxification10065.401NANA 3622Carrier 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 education10065.401NANA 3623Carrier 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 Inpat100001NANA 3624Carrier 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)100001NANA 3625Carrier 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 Inpatien100001NANA 3626Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin2580.876.954.510248NANA 3627Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica2020.867852.44198NANA 3628Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1760.833.543.911165NANA 3629Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor1740.835659.88166NANA 3630Carrier 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 plan930.732.458.31479NANA 3631Carrier 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 minutes930.7431.650.81875NANA 3632Carrier 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 session920.7316.553.81181NANA 3633Carrier 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 minutes900.7232.253.32169NANA 3634Carrier H2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem860.7217.145.3779NANA 3635Carrier 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 minutes790.7232.451.21861NANA 3636Carrier 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 Profess9124918NANA 3637Carrier 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 Or9124918NANA 3638Carrier 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 Health811208NANA 3639Carrier 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 Pr812410.317NANA 3640Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480Intensive Outpatient Psychiatric Services Per Diem7103316NANA 3641Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours612806NANA 3642Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870Electroconvulsive Therapy;1 Seizure21002NANA 3643Carrier H2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2014Skills Training And Development Per 15 Minutes112401NANA 3644Carrier 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, Includin258016.954.510248NANA 3645Carrier 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 Cortica202017852.44198NANA 3646Carrier 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 Motor174015659.88166NANA 3647Carrier 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 Patie440174.4451133NANA 3648Carrier 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 Patie310182.745.21021NANA 3649Carrier H2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ3490Unclassified drugs300.3326.4121.921NANA 3650Carrier 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 plan9300.0232.458.31479NANA 3651Carrier 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 minutes7900.0132.451.21861NANA 3652Carrier 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 minutes9000.0132.253.32169NANA 3653Carrier 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 minutes9300.0131.650.81875NANA 3654Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Adjustable, Custom Fabricated, Includes Fitting And Adjustment2080.957.701329NANA 3655Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified990.843099NANA 3656Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ710.94056.9269NANA 3657Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each480.9224105.4147NANA 3658Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr410.8062.4140NANA 3659Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications360.362487.2135NANA 3660Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (Non-Invasive)320.254888.6329NANA 3661Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination270.892436126NANA 3662Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0606Aed Garment With Electrocardiogram Analysis260.5821.872242NANA 3663Carrier H2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8688Implt Nrostm Pls Gen Dua Non230.87109.4023NANA 3664Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8691Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/Actuator, R9197.709NANA 3665Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8694Auditory Osseointegrated Device, Transducer/Actuator, Replacement Only, Each8161.708NANA 3666Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair Accessory, Headrest, Cushioned, Prefabricated, Including Fixed Mounting Hardwar6167.206NANA 3667Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6549Gradient compression stocking/sleeve, not otherwise specified5160.405NANA 3668Carrier 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 supply4132.8169.531NANA 3669Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0277Alternating Pressure Mattress4104813NANA 3670Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1233Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating312403NANA 3671Carrier 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 Rails315603NANA 3672Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8687Implt Nrostm Pls Gen Dua Rec3110803NANA 3673Carrier H2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8681Pt Prgrm For Implt Neurostim3115603NANA 3674Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0486Adjustable, Custom Fabricated, Includes Fitting And Adjustment208017.701329NANA 3675Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8680Implantable Neurostimulator Electrode Each480124105.4147NANA 3676Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications36012487.2135NANA 3677Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0005Ultralightweight Wheelchair220158.7022NANA 3678Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8614Cochlear Device/System1401112014NANA 3679Carrier 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, R90197.709NANA 3680Carrier 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, Each80161.708NANA 3681Carrier 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, Each4017204NANA 3682Carrier H2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0277Alternating Pressure Mattress40104813NANA 3683Carrier 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 Extens3018003NANA 3684Carrier H2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATest Strips1070.62931.22978NANA 3685Carrier H2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANATest Strips1070.62931.22978NANA 3686Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47379UNLISTED LAPS PX LIVER20.50600020NANA 3687Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY21000020NANA 3688Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405REPLACEMENT AORTIC VALVE OPN2172240110NANA 3689Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL HYSTERECTOMY11000010NANA 3690Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21705REVISION OF NECK MUSCLE/RIB1001200010NANA 3691Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33464VALVULOPLASTY TRICUSPID11000010NANA 3692Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21175RECONSTRUCT ORBIT/FOREHEAD11000010NANA 3693Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32662THORACOSCOPY W/MEDIAST EXC11000010NANA 3694Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44205LAP COLECTOMY PART W/ILEUM11000010NANA 3695Carrier N2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHRD CMBN 1NTRSPC LUMBAR1003120010NANA 3696Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY21000020NANA 3697Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACEMENT AORTIC VALVE OPN2172240110NANA 3698Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL HYSTERECTOMY11000010NANA 3699Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33464VALVULOPLASTY TRICUSPID11000010NANA 3700Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21175RECONSTRUCT ORBIT/FOREHEAD11000010NANA 3701Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32662THORACOSCOPY W/MEDIAST EXC11000010NANA 3702Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44205LAP COLECTOMY PART W/ILEUM11000010NANA 3703Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240TRANSPLT ALLO HCT/DONOR11000100NANA 3704Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37215TRANSCATH STENT CCA W/EPS110240010NANA 3705Carrier N2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43659UNLISTED LAPS PX STOMACH110240010NANA 3706Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY3310133.100330NANA 3707Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM310.839015100310NANA 3708Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA280.82172419.503250NANA 3709Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE160.9389656.602140NANA 3710Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM140.7860222.900140NANA 3711Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT36471NJX SCLRSNT MLT INCMPTNT VN140.8570330.900140NANA 3712Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30-39 MIN130.6150127.400130NANA 3713Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA120.8331257.602100NANA 3714Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT36475ENDOVENOUS RF 1ST VEIN120.917066600120NANA 3715Carrier N2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION100.9031.200100NANA 3716Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY3310133.100330NANA 3717Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM260.839098.800260NANA 3718Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA230.82196468.602210NANA 3719Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE150.9389660.902130NANA 3720Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36471NJX SCLRSNT MLT INCMPTNT VN120.857036800120NANA 3721Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVENOUS RF 1ST VEIN110.9170717.800110NANA 3722Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM110.7860117.800110NANA 3723Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9299INJECTION, NIVOLUMAB1010962.70190NANA 3724Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81162BRCA1&2 GEN FULL SEQ DUP/DEL10106000100NANA 3725Carrier N2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA100.83312390280NANA 3726Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89356Reproductive Medicine10104800010NANA 3727Carrier 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 Reconstruction10103840010NANA 3728Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43239Surgery Digestive System10109120010NANA 3729Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22842Posterior segmental instrumentation1012400100NANA 3730Carrier N2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27096Injection procedure for sacroiliac joint1014800100NANA 3731Carrier N2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANASubstance Use Residential21122NANA 3732Carrier N2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADetox11121NANA 3733Carrier N2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANASubstance Use Residential21122NANA 3734Carrier N2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADetox11121NANA 3735Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMH IP1012400100NANA 3736Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMH RES1017200100NANA 3737Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANACD RES1014800100NANA 3738Carrier N2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANASA RES1012400100NANA 3739Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TCRANIAL MAGN STIM TX DELI50.664.125NANA 3740Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BEHAVIOR TX PHYS/QHP20.536.232NANA 3741Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYTX W PT 60 MINUTES11121NANA 3742Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0015ALCOHOL AND/OR DRUG SERVICES11135.91NANA 3743Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BHV ID ASSMT BY PHYS/QHP11126.151NANA 3744Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS0201PARTIAL HOSPITALIZATION SERV11121NANA 3745Carrier N2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H1198.281NANA 3746Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90868TCRANIAL MAGN STIM TX DELI30.636.163NANA 3747Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYTX W PT 60 MINUTES11121NANA 3748Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPT BEHAVIOR TX PHYS/QHP10.572.151NANA 3749Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0015ALCOHOL AND/OR DRUG SERVICES11135.91NANA 3750Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BHV ID ASSMT BY PHYS/QHP11126.151NANA 3751Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS0201PARTIAL HOSPITALIZATION SERV11121NANA 3752Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H1198.281NANA 3753Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151ABA10101920010NANA 3754Carrier N2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155MH OIF10101440010NANA 3755Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXT AMB INFUSN PUMP INSULIN51050000NANA 3756Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0466HOME VENT NON-INVASIVE INTER31030000NANA 3757Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR20.667020000NANA 3758Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8688IMPLT NROSTM PLS GEN DUA NON11010000NANA 3759Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2599SGD ACCESSORY NOC11010000NANA 3760Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2510SGD W MULTI METHODS MSG/ACCS11010000NANA 3761Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT11010000NANA 3762Carrier N2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11010000NANA 3763Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXT AMB INFUSN PUMP INSULIN51050000NANA 3764Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0466HOME VENT NON-INVASIVE INTER31030000NANA 3765Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR20.667020000NANA 3766Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8688IMPLT NROSTM PLS GEN DUA NON11010000NANA 3767Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2599SGD ACCESSORY NOC11010000NANA 3768Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2510SGD W MULTI METHODS MSG/ACCS11010000NANA 3769Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT11010000NANA 3770Carrier N2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11010000NANA 3771Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA920.617.3156.4016760OZEMPIC 0.25 OR .5 PEN INJCTRNA 3772Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA550.890.0990.64010450OZEMPIC 1/0.75 (3) PEN INJCTRNA 3773Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA420.8131.5759.6014280NURTEC ODT 75 MG TAB RAPDISNA 3774Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA3510.210.13019160ELIQUIS 5 MG TABLETNA 3775Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA330.853.07155.8309240DEXCOM G6 EACH/DEXCOM G6 SENSOR EACHNA 3776Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA330.820.0229.31010230TRULICITY 0.75MG/0.5 PEN INJCTRNA 3777Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA290.863.94138.34013160STELARA 90 MG/ML SYRINGENA 3778Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA270.345.99122.4108190DESCOVY 200MG-25MG TABLETNA 3779Carrier 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 KITNA 3780Carrier N2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA240.792.8151.704200DEXCOM G6 EACH/DEXCOM G6 TRANSMITTER EACHNA 3781Carrier 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 KITNA 3782Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA2110.011.2904170TRULICITY 1.5 MG/0.5 PEN INJCTRNA 3783Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA18116.3719.6904140DEXTROAMPHETAMINE-AMPHET ER 20 MG CAP.SR 24HNA 3784Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1610.0242.9303130ENBREL SURECLICK 50MG/ML(1) PEN INJCTRNA 3785Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1411.2843.4902120STELARA 45MG/0.5ML SYRINGENA 3786Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1410.0112.0602120TRULICITY 3 MG/0.5ML PEN INJCTRNA 3787Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1310.010.010490DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLETNA 3788Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1213.0625.090930MENOPUR 75 UNIT VIALNA 3789Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1110.133.0401100SKYRIZI PEN 150 MG/ML PEN INJCTRNA 3790Carrier N2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA101047.3100100OTEZLA 30 MG TABLETNA 3791Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES4123.718.713NANA 3792Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue367OPERATING ROOM SERVICES, KIDNEY TRANSPLANT4146.64NANA 3793Carrier 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 MINUTES2145.42NANA 3794Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21662NANA 3795Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT23586REFERRAL REHAB, ACUTE2102NANA 3796Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue333RADIOLOGY, THERAPEUTIC AND/OR CHEMO ADMIN - RADIATION THERAPY2170.22NANA 3797Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL212.950.611NANA 3798Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS4042MANAGEMENT OF OVULATION INDUCTION PER CYCLE1197.81NANA 3799Carrier E2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCD0501HISTOPATHOLOGIC EXAMINATIONS1101NANA 3800Carrier 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 21101NANA 3801Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES4123.718.713NANA 3802Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue367OPERATING ROOM SERVICES, KIDNEY TRANSPLANT4146.64NANA 3803Carrier 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 MINUTES2145.42NANA 3804Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71046RADIOLOGIC EXAM CHEST 2 VIEWS21662NANA 3805Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT23586REFERRAL REHAB, ACUTE2102NANA 3806Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue333RADIOLOGY, THERAPEUTIC AND/OR CHEMO ADMIN - RADIATION THERAPY2170.22NANA 3807Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL212.950.611NANA 3808Carrier E2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCD0501HISTOPATHOLOGIC EXAMINATIONS1101NANA 3809Carrier 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 21101NANA 3810Carrier 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 2110.11NANA 3811Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES4080.99514.335.726382NANA 3812Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS2730.96347.536.413260NANA 3813Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96040MEDICAL GENETICS COUNSELING EACH 30 MINUTES16610.521.1115.831621NANA 3814Carrier 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 TQ114130.7114NANA 3815Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST107110.730.63968NANA 3816Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES9318.345.1291NANA 3817Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN810.975326.738.2378NANA 3818Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0151SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN761376NANA 3819Carrier E2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST7417.924.32252NANA 3820Carrier 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 MIN720.819457.672NANA 3821Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040MEDICAL GENETICS COUNSELING EACH 30 MINUTES16610.521.1115.831621NANA 3822Carrier 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 TQ114130.7114NANA 3823Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST107110.730.63968NANA 3824Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES9318.345.1291NANA 3825Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0151SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN761376NANA 3826Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST7417.924.32252NANA 3827Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST721622.34131NANA 3828Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD6613.836.6165NANA 3829Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST64111.119.74123NANA 3830Carrier E2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS5511042.6253NANA 3831Carrier 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 MIN7200.013957.672NANA 3832Carrier 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 D1600.06252559.5115NANA 3833Carrier 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 MATERIAL900.11111.161.918NANA 3834Carrier 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 MG600.166745.649.715NANA 3835Carrier E2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23683EXT REFERRAL OBGYN500.2695NANA 3836Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC41115.726392NANA 3837Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP32142.512.8302NANA 3838Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION20123.6383.41181NANA 3839Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV12146.412NANA 3840Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC10132.610NANA 3841Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue154ROOM & BOARD, WARD - PSYCHIATRIC2124.22NANA 3842Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES110.51NANA 3843Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99220INITIAL OBSERVATION CARE/DAY 70 MINUTES1195.91NANA 3844Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE110.21NANA 3845Carrier E2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION1150.11NANA 3846Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC41115.726392NANA 3847Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP32142.512.8302NANA 3848Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION20123.6383.41181NANA 3849Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV12146.412NANA 3850Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC10132.610NANA 3851Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue154ROOM & BOARD, WARD - PSYCHIATRIC2124.22NANA 3852Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES110.51NANA 3853Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99220INITIAL OBSERVATION CARE/DAY 70 MINUTES1195.91NANA 3854Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE110.21NANA 3855Carrier E2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION1150.11NANA 3856Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION5220.990441522NANA 3857Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES106144.9106NANA 3858Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN56150.256NANA 3859Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE23115.783.9203NANA 3860Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION18127.520.1171NANA 3861Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS17148.538.7161NANA 3862Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN15114.215NANA 3863Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES13151.213NANA 3864Carrier E2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905BEHAVIORAL HEALTH TREATMENTS/SVCS, INTENSIVE OP, PSYCHIATRIC13126.413NANA 3865Carrier 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 MIN11137.511NANA 3866Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES106144.9106NANA 3867Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN56150.256NANA 3868Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE23115.783.9203NANA 3869Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION18127.520.1171NANA 3870Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS17148.538.7161NANA 3871Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN15114.215NANA 3872Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY W/PATIENT 45 MINUTES13151.213NANA 3873Carrier E2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue905BEHAVIORAL HEALTH TREATMENTS/SVCS, INTENSIVE OP, PSYCHIATRIC13126.413NANA 3874Carrier 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 MIN11137.511NANA 3875Carrier 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 MIN10130.410NANA 3876Carrier E2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION52100.001941521NANA 3877Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S160112.317.55155NANA 3878Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1330.9854.917.115118NANA 3879Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR1210.99179.510.78113NANA 3880Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR860.98847.9261076NANA 3881Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION81127.981NANA 3882Carrier 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 SHOE71150.971NANA 3883Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2810.315.3127NANA 3884Carrier 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 PANEL23123.923NANA 3885Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1846KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM22177.922NANA 3886Carrier E2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP2215.713.6418NANA 3887Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S160112.317.55155NANA 3888Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION81127.981NANA 3889Carrier 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 SHOE71150.971NANA 3890Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2810.315.3127NANA 3891Carrier 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 PANEL23123.923NANA 3892Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1846KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM22177.922NANA 3893Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY PUMP2215.713.6418NANA 3894Carrier 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/LESS22143.222NANA 3895Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7005NONDISPOSABLE NEBULIZER SET2015.220NANA 3896Carrier E2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1900AFO SPRNG WIR DRSFLX CALF BD191107.619NANA 3897Carrier E2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0651PNEUM COMPRESSOR SEGMENTAL300.333360.23NANA 3898Carrier 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 subcutaneou670.388129.267NANA 3899Carrier 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 SERVICE43190.443NANA 3900Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL28194.728NANA 3901Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4211SUPP FOR SELF-ADM INJECTIONS23122.810.3122NANA 3902Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21135.621NANA 3903Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN151129.815NANA 3904Carrier 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 DRESS31408.43NANA 3905Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4456ADHESIVE REMOVER WIPES ANY TYPE EACH213312NANA 3906Carrier E2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1129.81NANA 3907Carrier 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 SPL110.11NANA 3908Carrier 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 SERVICE43190.443NANA 3909Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL28194.728NANA 3910Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4211SUPP FOR SELF-ADM INJECTIONS23122.810.3122NANA 3911Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC21135.621NANA 3912Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN151129.815NANA 3913Carrier 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 DRESS31408.43NANA 3914Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4456ADHESIVE REMOVER WIPES ANY TYPE EACH213312NANA 3915Carrier E2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS1129.81NANA 3916Carrier 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 SPL110.11NANA 3917Carrier 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 subcutaneou670.388129.267NANA 3918Carrier 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 subcutaneou6700.014929.267NANA 3919Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1220.819723.9115573801220EMPAGLIFLOZINNA 3920Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA660.469730.936603540660VARENICLINE TARTRATENA 3921Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA570.964918.109293370570UBROGEPANTNA 3922Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA510.647117.958186270510INSULIN GLARGINENA 3923Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA49129.887551020490RIVAROXABANNA 3924Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA450.488925.214666670450SEMAGLUTIDENA 3925Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA400.97513.007409720400SECUKINUMABNA 3926Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA390.974417.964700850390FREMANEZUMAB-VFRMNA 3927Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA350.628627.687111110350LISDEXAMFETAMINE DIMESYLATENA 3928Carrier E2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA35114.157507940350ADALIMUMABNA 3929Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA49129.887551020490RIVAROXABANNA 3930Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA35114.157507940350ADALIMUMABNA 3931Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA28176.13976190280TICAGRELORNA 3932Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA11121.822575760110GALCANEZUMAB-GNLMNA 3933Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10110.724916670100GUSELKUMABNA 3934Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5112.0475050VORTIOXETINE HBRNA 3935Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5128.54044444050BREXPIPRAZOLENA 3936Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4117.31354167040ABATACEPTNA 3937Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4137.44520833040EMTRICITABINE-TENOFOVIR ALAFENAMIDE FUMARATENA 3938Carrier E2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA318.633796296030LACOSAMIDENA 3939Carrier E2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA5100.019617.958186270510INSULIN GLARGINENA 3940Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD110800.992218241106020NANA 3941Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD770.9737153761NANA 3942Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV400.95224139NANA 3943Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV2516025NANA 3944Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST190.8947916316NANA 3945Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533CABG USING ART GRFTS 1 ART GRFT150.8210510NANA 3946Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU150.82595411NANA 3947Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY130.92311.511211NANA 3948Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT35301THROMBOENDARTECTMY NECK,NECK INCIS110.818214011NANA 3949Carrier C2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO90.777893136NANA 3950Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV2516025NANA 3951Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551ARTHRODESIS ANT INTERBODY CERVICAL BELOW C271183516NANA 3952Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663THORACOSCOPY SURG W/ LOBECTOMY TOTAL/SEGMEN713907NANA 3953Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT762MISC SERVICES619360NANA 3954Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32650THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA6101.524NANA 3955Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59410VAG DELIVERY ONLY W/ POSTPARTUM CARE41004NANA 3956Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59514CESAREAN DELIVERY ONLY410713NANA 3957Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY314403NANA 3958Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239UPPER GI ENDO W/ BX SINGLE/MULT318403NANA 3959Carrier C2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43280LAP,ESOPHAGOGAST FUNDOPLASTY312403NANA 3960Carrier C2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT120ROOM AND BOARD1108000.000118241106020NANA 3961Carrier 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 MINS923710.96774.713.6967982692NANA 3962Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES112940.93686.317.639110903NANA 3963Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE103970.98761718310214NANA 3964Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT70420.974614.53426700NANA 3965Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES47480.992817447471NANA 3966Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER23820.97362.7142632119NANA 3967Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43235UPPER GI ENDO DX (SEP PROC)19450.963515.51791766NANA 3968Carrier 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 MINS19420.91977293341608NANA 3969Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERA ACTVI DIRECT PAT CONTACT EA 15 MIN17470.95258.522.3881659NANA 3970Carrier C2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN16290.96385.316.3771552NANA 3971Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58300INSERT INTRAUTERINE DEVICE136124.731105NANA 3972Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ3301TRIAMCINOLONE ACETONIDE INJ PER 10 MG12611205121NANA 3973Carrier 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/EXPRESSION114108.71113NANA 3974Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17260DESTRUCT MALIG LES TRUNK/ARM/LEG < 0.5 CM11210.62.58104NANA 3975Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT51798MEASUREMENT PVR URIN&/BLADD CAPACTY US NON-IMAG92148290NANA 3976Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92526TX SWALLOWING DYSFUNCTION &/OR ORAL FUNCTION FEED681435.4761NANA 3977Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95115PROFES SVC IMMUNOTHER NON-PROV EXTRACT SINGLE INJ6510.311.3362NANA 3978Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77001FLUORO GUIDE FOR CENT VENOUS ACCESS DEVICE6215.471151NANA 3979Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT559OTHER THERAPY SERV591158.5059NANA 3980Carrier C2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92960CARDIOVERSION ELECTIVE EXT5710.591047NANA 3981Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT50688CHANGE URETEROSTOMY TUBE1011901NANA 3982Carrier 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, LUMBAR200.516802NANA 3983Carrier 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/DYE200.512502NANA 3984Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT76390MRI SPECTROSCOPY200.56502NANA 3985Carrier 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 TX400.252422NANA 3986Carrier 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; THORACIC500.224.33932NANA 3987Carrier C2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61885INSRT/REDO NEUROSTIM 1 ARRAY500.216124.323NANA 3988Carrier 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+1000.20.564.828NANA 3989Carrier 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&RNA600.16673.548.824NANA 3990Carrier 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 IMG800.12513.577.326NANA 3991Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ROOM AND BOARD5690.98427.3115672NANA 3992Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3450.982629173432NANA 3993Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV3330.98522343321NANA 3994Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ROOM AND BOARD1530.9935141530NANA 3995Carrier C2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD115810NANA 3996Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD115810NANA 3997Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ROOM AND BOARD1530.9935141530NANA 3998Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV3330.98522343321NANA 3999Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ROOM AND BOARD5690.98427.3115672NANA 4000Carrier C2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD3450.982629173432NANA 4001Carrier C2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT124ROOM AND BOARD56900.00537.3115672NANA 4002Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT108300.99633826910561NANA 4003Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS31060.9974551063000NANA 4004Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY7240.99596.668716NANA 4005Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES5940.99165.516.725569NANA 4006Carrier 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 MINS2840.92611081807277NANA 4007Carrier 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 HOUR2440.97546.714.33241NANA 4008Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT2110.772561.70211NANA 4009Carrier 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 MINS1520.815847.81406146NANA 4010Carrier 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 MINS1270.99211.352125NANA 4011Carrier C2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS127129.23124NANA 4012Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS127129.23124NANA 4013Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES4714326146NANA 4014Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT18121018NANA 4015Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT617306NANA 4016Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT414513NANA 4017Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN213.502NANA 4018Carrier C2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806IND PSYCHOTHERAPY OFFICE 45-50 MIN11801NANA 4019Carrier 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 HOUR111801NANA 4020Carrier 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 MINS113801NANA 4021Carrier 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 MINS1113701NANA 4022Carrier 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 ADMIM2300.04358859.3320NANA 4023Carrier 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 & MGMT21100.037961.70211NANA 4024Carrier C2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT1083000.00013826910561NANA 4025Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE45520.986617.5984454NANA 4026Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE44160.93611.528.48943522NANA 4027Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE20210.99361.2241876145NANA 4028Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL11410.97021.323736405NANA 4029Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT6870.97671.714333354NANA 4030Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT6870.9942811.73684NANA 4031Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR6240.99251621603NANA 4032Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH5240.97142.328176348NANA 4033Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE4780.97912.311.4148330NANA 4034Carrier C2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP4380.99090.611.39429NANA 4035Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND371187.32369NANA 4036Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR24710.51018463NANA 4037Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4670AUTOMATIC BP MONITOR DIAL12910.7613116NANA 4038Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4338INDWELLING CATH LATEX1181168434NANA 4039Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4387WALKING BOOT, PREFAB, NONPNEUMATIC821159181NANA 4040Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4397PLANTAR FASCITIS NIGHT SPLINT4718.4047NANA 4041Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB4411.413836NANA 4042Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0849TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE4310.111142NANA 4043Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0484OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEV, NONELEC, ANY TYPE, EACH4113.621.31724NANA 4044Carrier C2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1951AFO, SPIRAL, PLASTIC OR OTHER, PREFAB41117041NANA 4045Carrier 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 EA300.66672603NANA 4046Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5321AK OPEN END SACH400.256704NANA 4047Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5981ALL LE PROSTHESES600.166710006NANA 4048Carrier 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 TYPE1000.13.714537NANA 4049Carrier 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 UNIT1700.0588108.3017NANA 4050Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL3000FOOT INSERT REMOV MOLDED TO PT15400.0065840.65149NANA 4051Carrier 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, NONINVAS19000.00531.531.746144NANA 4052Carrier 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 PORTABLE20400.004921.779.617628NANA 4053Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0001WHEELCHAIR STANDARD27700.0036219104173NANA 4054Carrier C2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL114100.00091.322.8736405NANA 4055Carrier 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 MINS16340.96942.615.61111523NANA 4056Carrier 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 ACCESSORIES8570.75037.361.7312545NANA 4057Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN4940.959561320474NANA 4058Carrier 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 SHOE2170.9447529.64213NANA 4059Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE1610.97521.53514219NANA 4060Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG1130.9646628.63083NANA 4061Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD109113.41090NANA 4062Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1060.801911872799NANA 4063Carrier C2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV950.9579631.51580NANA 4064Carrier 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 SPL760.9079152.33739NANA 4065Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD109113.41090NANA 4066Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA4511.315.52421NANA 4067Carrier 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 RECORDING20111.6020NANA 4068Carrier 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 DY19154.4019NANA 4069Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT762MISC SERVICES15119.3150NANA 4070Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67210DESTRUCT LOCALIZED RET LES 1+ SESS PHOTOCOAGULA10173928NANA 4071Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH912309NANA 4072Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ2778LUCENTIS 0.1MG, INJECTION910.12618NANA 4073Carrier 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/REP7145.607NANA 4074Carrier C2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE7115.607NANA 4075Carrier 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 ACCESSORIES85700.00237.361.7312545NANA 4076Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD44620.986118.432444517NANA 4077Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV291623128NANA 4078Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD27123270NANA 4079Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU90.8889299118NANA 4080Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533CABG USING ART GRFTS 1 ART GRFT810.71535NANA 4081Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV810417NANA 4082Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y716007NANA 4083Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY60.5411115NANA 4084Carrier D2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY6111624NANA 4085Carrier 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 MINUTES6101415NANA 4086Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV291623128NANA 4087Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD27123270NANA 4088Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33533CABG USING ART GRFTS 1 ART GRFT810.71535NANA 4089Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV810417NANA 4090Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y716007NANA 4091Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY6111624NANA 4092Carrier 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 MINUTES6101415NANA 4093Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32666THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT511.53523NANA 4094Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO5130.523NANA 4095Carrier D2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST513605NANA 4096Carrier 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 MINS239910.9911320241521576NANA 4097Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES28510.98354.720.71232728NANA 4098Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT762MISC SERVICES22020.990915.6422011NANA 4099Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE17790.9899414.5341745NANA 4100Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT14200.9944171101310NANA 4101Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,8280.751214.755117711NANA 4102Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER8090.992621968741NANA 4103Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JOINT6250.859694658567NANA 4104Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72158MRI LUMBAR W/WO CONTRST SPINE6190.3327.793.361558NANA 4105Carrier D2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL5950.8021040.7132463NANA 4106Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77080DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE27210.21915257NANA 4107Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY22512.41218207NANA 4108Carrier 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 BLCK16011.31229131NANA 4109Carrier 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 ECP1581320.519139NANA 4110Carrier 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)991324198NANA 4111Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17000DESTRUCT 1ST AK PREMALIG LESION9212.720.4389NANA 4112Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29881KNEE SCOPE,MED/LAT MENISECTOMY W/DEBRIDE/CHONDRO881116385NANA 4113Carrier 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 MINS871233.5384NANA 4114Carrier 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.7012.432763NANA 4115Carrier D2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95863EMG NEEDLE 3 EXTREMITIES W/WO RELATED PARASPINAL691115564NANA 4116Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT10060I & D ABSCESS SIMP/SINGLE400.251460.522NANA 4117Carrier 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, ABDOMEN500.2122.405NANA 4118Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63685INSRT/REDO SPINE N GENERATOR500.26505NANA 4119Carrier 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 TX600.1667104224NANA 4120Carrier 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 NEWBORN800.125358.317NANA 4121Carrier 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 VAR900.1111488.336NANA 4122Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99183PHYSICN ATTENDNCE HYPERBARIC OXYGEN THERAPY900.111110009NANA 4123Carrier 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 BODY1000.19597.719NANA 4124Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70336MRI TEMPOROMANDIBULAR JOINT1400.07141150311NANA 4125Carrier D2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0402TCOLLAGEN CROSS-LINKING OF CORNEA1700.05881766215NANA 4126Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT124ROOM AND BOARD2680.9925512671NANA 4127Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128ROOM AND BOARD1570.9936291570NANA 4128Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV143131.61430NANA 4129Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT126ROOM AND BOARD41111410NANA 4130Carrier D2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD11710NANA 4131Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT900OTHER THERAPY SERV143131.61430NANA 4132Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126ROOM AND BOARD41111410NANA 4133Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD11710NANA 4134Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128ROOM AND BOARD1570.9936291570NANA 4135Carrier D2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT124ROOM AND BOARD2680.9925512671NANA 4136Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT12430.99521.513.6631180NANA 4137Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS4290.99774331398NANA 4138Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES1690.982248.59160NANA 4139Carrier 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 MINS850.9176180085NANA 4140Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY7518.7075NANA 4141Carrier D2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT720.736176.6072NANA 4142Carrier 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 HOUR5216118151NANA 4143Carrier 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 MINS510.8431170051NANA 4144Carrier 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 MINS38115137NANA 4145Carrier 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 HOUR370.9189113.7136NANA 4146Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY7518.7075NANA 4147Carrier 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 HOUR5216118151NANA 4148Carrier 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 MINS38115137NANA 4149Carrier 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 MINS714707NANA 4150Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE514605NANA 4151Carrier 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 MONTH2110802NANA 4152Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ2315NALTREXONE, DEPOT FORM, 1 MG INJECTION212602NANA 4153Carrier D2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS11001NANA 4154Carrier 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 HOUR1124601NANA 4155Carrier 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 MINS110.501NANA 4156Carrier 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 & MGMT7200.0476.6072NANA 4157Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE16640.95921.423.71861478NANA 4158Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE10900.987211291081NANA 4159Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE7060.99581.52463769NANA 4160Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT3530.96880.2152351NANA 4161Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR3010.9701214.45296NANA 4162Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL2600.953822616793NANA 4163Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP2170.9447170217NANA 4164Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND2120.9858180212NANA 4165Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT2020.9653224.410399NANA 4166Carrier D2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA1810.977915151180NANA 4167Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE9912.715.53168NANA 4168Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN891128.6683NANA 4169Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR6411.67.64519NANA 4170Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0935PASSIVE EXERCISE DEVICE48123048NANA 4171Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1820KO ELAS W/ CONDYLE PADS & JO42113.5042NANA 4172Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4387WALKING BOOT, PREFAB, NONPNEUMATIC41111041NANA 4173Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0431PORTABLE GASEOUS 02391419.52613NANA 4174Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1852KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH/CALF, PREFAB, OFF-THE-SHELF361319.7630NANA 4175Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8030DME BREAST PROTHESIS ONLY361615333NANA 4176Carrier D2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB3211.422329NANA 4177Carrier 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 & COMP200.58502NANA 4178Carrier 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 MINS3500.05713679.7530NANA 4179Carrier 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 MINS4630.98722140423NANA 4180Carrier 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 ACCESSORIES3470.729111.377135212NANA 4181Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN1480.99322.62711137NANA 4182Carrier 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 SHOE690.95650.328.7168NANA 4183Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG631328.5855NANA 4184Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP480.62512.594642NANA 4185Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE471215398NANA 4186Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT120ROOM AND BOARD41112.4410NANA 4187Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG340.9412725430NANA 4188Carrier D2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV331248.6528NANA 4189Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG631328.5855NANA 4190Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE471215398NANA 4191Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT120ROOM AND BOARD41112.4410NANA 4192Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV331248.6528NANA 4193Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA10132655NANA 4194Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT762MISC SERVICES9128.390NANA 4195Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67228DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN910.53527NANA 4196Carrier 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 RECORDING812508NANA 4197Carrier 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, EACH810.410526NANA 4198Carrier D2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11042DEBRIDE SKIN & SUBQ TISSUE7171.707NANA 4199Carrier 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 PUMP4800.041712.594642NANA 4200Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT MATERIAL ATTACHED TO SPINE110.7273141.4600110NANA 4201Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT TO BONE DURING SPINAL SURGERY101143.2900100NANA 4202Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853METALLIC MESH BETWEEN VERTEBRAE9172.440090NANA 4203Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44620CLOSURE OF INTESTINAL DIVERSION6115.2174.20240NANA 4204Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPIC PARTIAL REMOVAL OF COLON6191.510060NANA 4205Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33533CORONARY ARTERY BYPASS WITH ARTERIAL GRAFT; 1 ARTERY6112.1559.660150NANA 4206Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9000DOXORUBICIN HCL INJECTION6155.9564.60240NANA 4207Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK5165.860050NANA 4208Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECOMY WITH TUBES AND OVARIES5126.6111.280140NANA 4209Carrier B2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614SPINAL FUSION TO JOIN TWO VERTEBRAE51200.190050NANA 4210Carrier 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 ARTERY1149.90010NANA 4211Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5119INJ RITUXIMAB-PVVR BIOSIMILAR RUXIENCE 10 MG4195.72610130NANA 4212Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32663SCOPE OF LUNGS WITH REMOVAL OF LOBE11125.970010NANA 4213Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13102COMPLEX REPAIR OF WOUND TO TRUNK 5CM OR LESS11154.880010NANA 4214Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33871TRANSVERSE AORTIC-ARCH GRAFT WITH CARDIAC BYPASS PREFERRED HYPOTHERMIA11100.230010NANA 4215Carrier 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 CM11142.880010NANA 4216Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61782SCAN PROCEDURE CRANIAL ADDON2124.7142.350110NANA 4217Carrier 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 BODY1163.580010NANA 4218Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2260MILRINONE LACTATE PER 5 ML113.270100NANA 4219Carrier B2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE21133.280020NANA 4220Carrier 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 ELBOW101154.880010NANA 4221Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19371PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE101142.880010NANA 4222Carrier 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 IMPLANT101142.880010NANA 4223Carrier 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 CM101154.880010NANA 4224Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT49568HERNIA REPAIR WITH MESH101142.880010NANA 4225Carrier 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 CM101142.880010NANA 4226Carrier 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 CM101142.880010NANA 4227Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19328REMOVAL INTACT BREAST IMPLANT101142.880010NANA 4228Carrier B2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350NIPPLE/AREOLA RECONSTRUCTION101142.880010NANA 4229Carrier 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 CM101142.880010NANA 4230Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN1060.669881.53124.790.0331022NANA 4231Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD1050.5524141.6201050NANA 4232Carrier 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 LEVEL1000.91114.060.0301001NANA 4233Carrier 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 MACHINE810.432119.11164.611800NANA 4234Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION,ONABOTULINUMTOXINA670.74632.1100.391660NANA 4235Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue551SKILLED NURSE VISIT IN HOME66125.4187.062640NANA 4236Carrier 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 GENE470.6596161.420460NANA 4237Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447REPAIR PROCEDURES ON THE FEMUR AND KNEE JOINT460.891360.920460NANA 4238Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-14440.1591115.240420NANA 4239Carrier B2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-7440.1591116.740420NANA 4240Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT69930COCHLEAR DEVICE IMPLANT WITH/WITHOUT MASTOID11192.52010NANA 4241Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9181ETOPOSIDE INJECTION515.027.29140NANA 4242Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ1756INJECTION IRON SUCROSE 1 MG1158.22100NANA 4243Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99205OFFICE/OUTPATIENT VISIT NEW111.04010NANA 4244Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27488REMOVAL TOTAL KNEE PROSTHETIC CEMENT WITH/WITHOUT SPACER1119.92010NANA 4245Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MANAGEMENT 30-39 MIN5186.19050NANA 4246Carrier 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 METHOD1155.4010NANA 4247Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99215OFFICE/OUTPATIENT VISIT ESTABLISHED11145.12010NANA 4248Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64714REVISION OF LOW BACK NERVE(S)1122.3010NANA 4249Carrier B2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99349HOME VISIT ESTABLISHED PATIENT41165.38040NANA 4250Carrier 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, BILATERALLY101000NANA 4251Carrier 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 ABDOMEN1010.09010NANA 4252Carrier 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, BILATERALLY101167.9010NANA 4253Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHOLOGICAL DIAGNOSTIC EVALUATION1010.02001NANA 4254Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77067SCREENING MAMMOGRAPHY101000NANA 4255Carrier 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 MINUTES101000NANA 4256Carrier 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 ELECTRODE200.5259.75020NANA 4257Carrier 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 REGIONS200.5331.18010NANA 4258Carrier B2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ1602GOLIMUMAB FOR IV USE 1MG300.3333170.58030NANA 4259Carrier 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 ORGAN400.25243.61040NANA 4260Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY570.9825020.2800570NANA 4261Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY451012.2100450NANA 4262Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED241038.4800200NANA 4263Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC91018.290090NANA 4264Carrier B2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue100ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY1107.630010NANA 4265Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED241038.4800200NANA 4266Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC91018.290090NANA 4267Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue100REMOVL EMBEDDED FB CONJUNCT INCI1107.630010NANA 4268Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY451012.2100450NANA 4269Carrier B2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY570.9825020.2800570NANA 4270Carrier B2022Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY5700.0175020.2800570NANA 4271Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY1610114.620140NANA 4272Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES131053.940120NANA 4273Carrier 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 PATIENT1010110.730.10101NANA 4274Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM91024.93090NANA 4275Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS61027.82060NANA 4276Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR51024.02050NANA 4277Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY41053.19040NANA 4278Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM31072.25030NANA 4279Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES21037.33020NANA 4280Carrier B2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN21072.74020NANA 4281Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue901BEHAVIORAL HEALTH TREATMENT SERVICES, ELECTROSHOCK11071.97010NANA 4282Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM31072.25030NANA 4283Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN21072.74020NANA 4284Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY1610114.620140NANA 4285Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR51024.02050NANA 4286Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870PSYCHOTHERAPY SESSION UNDER 60 MINUTES41053.19040NANA 4287Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES21037.33020NANA 4288Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM91024.93090NANA 4289Carrier B2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015IOP AL &/OR DRG SRV->=3HRS DA/3DAWK110000NANA 4290Carrier 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 PATIENT1010110.730.10101NANA 4291Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE2820.953919.7490.26022770NANA 4292Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR710.929656.951.8706630NANA 4293Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS380.921187.7800380NANA 4294Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP240.95832.39139.9801220NANA 4295Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP180.944467.25102.2901170NANA 4296Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE8197.10070NANA 4297Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP7189.580060NANA 4298Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR70.714314.6967.130340NANA 4299Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM6199.240060NANA 4300Carrier B2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604HOSP GRADE ELECTRIC BREAST PUMP30.6667102.690030NANA 4301Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005ULTRALIGHTWEIGHT WHEELCHAIR1171.30010NANA 4302Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2202MANUAL WHEELCHAIR NON-STANDARD SEAT FRAME WIDTH, 24-27 INCHES11223.020100NANA 4303Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9342HOME THERAPY1122.170100NANA 4304Carrier 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 CLASSIFIED11286.140010NANA 4305Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2611GENERAL WHEELCHAIR BACK CUSSION WIDTH < 22 INCHES, ANY HEIGHT MOUNT HARDWARE1171.290010NANA 4306Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM6199.240060NANA 4307Carrier 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,11124.030010NANA 4308Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260HOSPITAL BED SEMI-ELEC WITH ANY RAILS WITH MATTRESS2121.7390.120110NANA 4309Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0637COMBINATION SIT TO STAND SYSTEM11285.970010NANA 4310Carrier B2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP7189.580060NANA 4311Carrier 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 WEARS3800.026387.7800380NANA 4312Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY780.974440.1793.7201770NANA 4313Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY130.8462137.5800130NANA 4314Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING110.9091124.6200110NANA 4315Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM8188.30080NANA 4316Carrier 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 TIME40122.190040NANA 4317Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN4174.10040NANA 4318Carrier B2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY30124.780030NANA 4319Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN4174.10040NANA 4320Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM8188.30080NANA 4321Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY780.974440.1793.7201770NANA 4322Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING110.9091124.6200110NANA 4323Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY130.8462137.5800130NANA 4324Carrier B2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0554THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY30124.780030NANA 4325Carrier 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 TIME40122.190040NANA 4326Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG160.68754.775.5115NANA 4327Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC130.61543.867.7211NANA 4328Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP120.91671157.848NANA 4329Carrier 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 SGM100.73.899.828NANA 4330Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE90.777822.117.218NANA 4331Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22600ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT90.77783.887.427NANA 4332Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST90.777823.919.927NANA 4333Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38724CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ90.666724.94027NANA 4334Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9100INJECTION CYTARABINE 100 MG80.7515.257.444NANA 4335Carrier G2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY80.87518.121.444NANA 4336Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION13162.513NANA 4337Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22558ARTHRD ANT INTERBODY MIN DSC LUMBAR7175.27NANA 4338Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49000EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX6111.31442NANA 4339Carrier 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 HR6120.645.933NANA 4340Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620CLOSURE ENTEROSTOMY LG/SMALL INTESTINE4133.198.122NANA 4341Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13101REPAIR COMPLEX TRUNK 2.6-7.5 CM3126.158.512NANA 4342Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13102REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM OR LT3126.158.512NANA 4343Carrier 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/1PCT3126.158.512NANA 4344Carrier 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/1PCT3126.158.512NANA 4345Carrier G2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE3172.63NANA 4346Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23440RESECTION/TRANSPLANTATION LONG TENDON BICEPS10196.21NANA 4347Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT50949UNLISTED LAPAROSCOPY PROCEDURE URETER10118.21NANA 4348Carrier 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 ABDOMINA10142.61NANA 4349Carrier 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 NRV10151.11NANA 4350Carrier 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 ANASTOMOSIS200.54825.611NANA 4351Carrier 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 DX200.518.273.611NANA 4352Carrier 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 R300.333321.237.512NANA 4353Carrier 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 AGE300.333319.2150.112NANA 4354Carrier 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 APPR300.333346.33NANA 4355Carrier G2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT44620CLOSURE ENTEROSTOMY LG/SMALL INTESTINE400.2533.198.122NANA 4356Carrier 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 D14150.90049.345.4281387NANA 4357Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT78452MYOCARDIAL SPECT MULTIPLE STUDIES2610.900458.83258NANA 4358Carrier 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 R2320.8707148.92230NANA 4359Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93971DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY1970.913714.522.123174NANA 4360Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77334TX DEVICES DESIGN AND CONSTRUCTION COMPLEX1710.92413.218.765106NANA 4361Carrier 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 ST1690.89942940.33166NANA 4362Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT ABDOMEN and PELVIS W/CONTRAST MATERIAL1500.890927.336.645105NANA 4363Carrier G2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585BOTULINUM TOXIN TYPE A PER UNIT1570.80257.463.110147NANA 4364Carrier 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-1480.9085043.71147NANA 4365Carrier 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 INTERPRETATION1460.917860.5146NANA 4366Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93271XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS321032NANA 4367Carrier 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 COM28148.1226NANA 4368Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93229XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT24124NANA 4369Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93280PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER241024NANA 4370Carrier 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 IMG191019NANA 4371Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9502TECHNETIUM TC-99M TETROFOSMIN DX PER STUDY DOSE18126.818NANA 4372Carrier 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 DFB171017NANA 4373Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77470SPECIAL TREATMENT PROCEDURE13122.1211NANA 4374Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93451RIGHT HEART CATH O2 SATURATION AND CARDIAC OUTPUT13140.9112NANA 4375Carrier G2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93990DUPLEX SCAN HEMODIALYSIS ACCESS131112NANA 4376Carrier 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 TISSUE1011611NANA 4377Carrier 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 MORSELIZED1012251NANA 4378Carrier 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 INCISION1012251NANA 4379Carrier 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 RIB101331NANA 4380Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23405TENOTOMY SHOULDER AREA 1 TENDON101331NANA 4381Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT40819EXC FRENUM LABIAL/BUCCAL101981NANA 4382Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT41115EXCISION LINGUAL FRENUM FRENECTOMY101981NANA 4383Carrier 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 COMPLETE101461NANA 4384Carrier G2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61783STEREOTACTIC COMPUTER ASSISTED PX SPINAL1012251NANA 4385Carrier 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 PLEXUS101331NANA 4386Carrier G2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric1101NANA 4387Carrier G2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board - Semiprivate - 2 Beds - Psychiatric1101NANA 4388Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG340.529499.334NANA 4389Carrier 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 M330.545599.833NANA 4390Carrier 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 MN240.5417102.224NANA 4391Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION120.66679842.3111NANA 4392Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES110.454572.54338NANA 4393Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT80307DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE80.3754092.717NANA 4394Carrier 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 MIN60.83331226NANA 4395Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96131PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR60.8333686NANA 4396Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTS9480INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM60.833332.360.733NANA 4397Carrier G2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR50.882.85NANA 4398Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR21185.52NANA 4399Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96121NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR21188.52NANA 4400Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR21185.52NANA 4401Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR21185.52NANA 4402Carrier 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-DIEM2172.52NANA 4403Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT80305DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE114011NANA 4404Carrier 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 MIN113501NANA 4405Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE111NANA 4406Carrier 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 TX11491NANA 4407Carrier G2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2012BEHAVIORAL HEALTH DAY TREATMENT PER HOUR11351NANA 4408Carrier G2022Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES1100.0972.656.138NANA 4409Carrier G2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN1617345.9115NANA 4410Carrier 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 SERVICE1101NANA 4411Carrier G2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT USE WITH NONDME INTRSTL CGM101NANA 4412Carrier G2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN1617345.9115NANA 4413Carrier 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 SERVICE1101NANA 4414Carrier 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 RATE780.628225.8114.5870NANA 4415Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS120.2568.212NANA 4416Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS100155.610NANA 4417Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1960AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB90.6667439NANA 4418Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE80.12538.38NANA 4419Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0466HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF80.519.880.344NANA 4420Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS8157.38NANA 4421Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS80.25133.68NANA 4422Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0108OTHER ACCESSORIES70.57141147NANA 4423Carrier G2022DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2628FABRICATION AND FITTING OF OCULAR CONFORMER70.857155.97NANA 4424Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58571LAPS TOTAL HYSTERECT 250 GM OR LT W/RMVL TUBE/OVARY1101NANA 4425Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA1175.61NANA 4426Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTB9998NOC FOR ENTERAL SUPPLIES11481NANA 4427Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0240BATH/SHOWER CHAIR W/WO WHEELS ANY SIZE1132.11NANA 4428Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0656SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK1193.51NANA 4429Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0986MNL WHEELCHAIR ACSS PUSH-RIM ACT PWR ASSIST SYS111NANA 4430Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1020RESIDUAL LIMB SUPPORT SYSTEM WHEELCHAIR ANY TYPE11961NANA 4431Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1161MANUAL ADULT SIZE WHEELCHAIR INCLUDES TILT SPACE11150.11NANA 4432Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1815DYN ADJ ANKLE EXT/FLEX DEVC INCL SOFT INTF MATL1199.21NANA 4433Carrier G2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2325PWR WC ACSS SIP AND PUFF INTERFCE NONPROPRTNAL11681NANA 4434Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL2999LOWER EXTREMITY ORTHOSES NOT OTHERWISE SPECIFIED101811NANA 4435Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4157ENTRAL F NUTRITION CMPL INHERITED DZ METAB200.5194811NANA 4436Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4649SURGICAL SUPPLY; MISCELLANEOUS400.25329531NANA 4437Carrier 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 CSTM500.253.55NANA 4438Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV500.2133.85NANA 4439Carrier 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 TYPE500.21599214NANA 4440Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2623PROSTHETIC EYE PLASTIC CUSTOM500.273.25NANA 4441Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2628FABRICATION AND FITTING OF OCULAR CONFORMER700.142955.97NANA 4442Carrier 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 INTF800.12519.880.344NANA 4443Carrier G2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS800.12557.38NANA 4444Carrier 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)490.881.78365569973.67917831544NANA 4445Carrier 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)460.852.82628865970.91364191442NANA 4446Carrier 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 pump3600.1295270676.0658810221323NANA 4447Carrier 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)290.831.14728072256.84775353722NANA 4448Carrier 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; lumbar280.961.95092027877.24536074127NANA 4449Carrier 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)2700.5512567221.804173671423NANA 4450Carrier 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)230.912.10708660662.80834108221NANA 4451Carrier 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)230.830.34780464386.78757963320NANA 4452Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9100Cytarabine Hcl 100 Mg Inj2200.0370333331.0147785071012NANA 4453Carrier 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; lumbar220.911.3848452558.50804957418NANA 4454Carrier J2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis2206.04509143522NANA 4455Carrier 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 allograft14186.0474187414NANA 4456Carrier 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)8112.3035455119.8537760326NANA 4457Carrier 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)511.65684560828.2805745732NANA 4458Carrier 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)4166.069012264NANA 4459Carrier 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 segment41102.65148834NANA 4460Carrier 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; lumbar4110.547317584NANA 4461Carrier 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 age4127.2522222230.3824363913NANA 4462Carrier 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; thoracic310.35368376519.4554952821NANA 4463Carrier 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 segment31103.11508323NANA 4464Carrier 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 array3137.562407413NANA 4465Carrier 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)3151.614188833NANA 4466Carrier 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, cervical31152.06048883NANA 4467Carrier 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 approach3117.237517323NANA 4468Carrier 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, cervical30.33152.06048883NANA 4469Carrier 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; lumbar280.071.95092027877.24536074127NANA 4470Carrier 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)150.070.13277777847.76105976114NANA 4471Carrier 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)460.072.82628865970.91364191442NANA 4472Carrier 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); lumbar210.052.10708660675.47881978219NANA 4473Carrier 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; lumbar220.051.3848452558.50804957418NANA 4474Carrier 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)230.042.10708660662.80834108221NANA 4475Carrier 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)490.041.78365569973.67917831544NANA 4476Carrier 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 flexibility54480.71.96735763123.238813862826.61002415543318NANA 4477Carrier 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 minutes51580.75.3288260924.466141531535.85453711514711NANA 4478Carrier 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 minutes46530.71.70930319524.26427263871.85104214463911NANA 4479Carrier 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 activities41860.690.70692594523.990699222004.755235441829NANA 4480Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete29610.944.2546396982764.829615NANA 4481Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis28510.940.4345833334.213635609122839NANA 4482Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr25970.880.2173611115.4166985081622.934375425933NANA 4483Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine18350.8833.277222225.8060296073096218333NANA 4484Carrier 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 saturation17430.966.8772222222.8207357361608417392NANA 4485Carrier J2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences15730.960.1297222223.4454402121473.848889215714NANA 4486Carrier 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)3315.8774831024.548783045627NANA 4487Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29898Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive2710.0377777782.3362931653043241NANA 4488Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75557Cardiac MRI for morph2516.34854444425NANA 4489Carrier 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 fractions20111.4252833343.97194503317NANA 4490Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72142Contrast MRI of cervical spine2010.01845833320NANA 4491Carrier 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 infarction20110.2006508317.92338387218NANA 4492Carrier 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 fractions19112.4130772246.59385613316NANA 4493Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72149Contrast MRI of lumbar spine1813.79422839518NANA 4494Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75635CTA abdm arta/lg artry w/o & w/cntrs1610.01300347216NANA 4495Carrier J2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72147Contrast MRI of thoracic spine1610.01277777816NANA 4496Carrier 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); thigh116351.9111671NANA 4497Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15879Suction assisted lipectomy; lower extremity116351.9111671NANA 4498Carrier 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 area116351.9111671NANA 4499Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15877Suction assisted lipectomy; trunk116351.9111671NANA 4500Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22849Reinsertion of spinal fixation device20.584.80557252NANA 4501Carrier 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, epidural20.572.497581952NANA 4502Carrier J2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22852Removal of posterior segmental instrumentation30.3377.097565913NANA 4503Carrier 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)50.25.458238057163.636878514NANA 4504Carrier 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; cervical110.1857.2516621211NANA 4505Carrier 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 labrum70.1451.253686657NANA 4506Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder2560.9813.4346571329.23745095494432531NANA 4507Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric550.832.1522222242.348606775365.357623522NANA 4508Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric191536.30154625.84960406217NANA 4509Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification2112.06753056487221NANA 4510Carrier 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.200.087308752NANA 4511Carrier 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)10238.92186581NANA 4512Carrier 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; unmonitored100.0872047231NANA 4513Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete10238.92186581NANA 4514Carrier 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, interpret100.0871611121NANA 4515Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9217Leuprolide Acetate Suspnsion100.0857352771NANA 4516Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services100.0058333341NANA 4517Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra10238.92186581NANA 4518Carrier 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 cm10238.92186581NANA 4519Carrier 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 approach10238.92186581NANA 4520Carrier 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.100.0875000021NANA 4521Carrier J2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0018Alcohol And/Or Drug Services100.08719639851.213NANA 4522Carrier 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.100.0875000021NANA 4523Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric191536.30154625.84960406217NANA 4524Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification2112.06753056487221NANA 4525Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder2560.9813.4346571329.23745095494432531NANA 4526Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric550.832.1522222242.348606775365.357623522NANA 4527Carrier 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.200.087308752NANA 4528Carrier 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)10238.92186581NANA 4529Carrier 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; unmonitored100.0872047231NANA 4530Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete10238.92186581NANA 4531Carrier 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, interpret100.0871611121NANA 4532Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9217Leuprolide Acetate Suspnsion100.0857352771NANA 4533Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0017Alcohol And/Or Drug Services100.0058333341NANA 4534Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra10238.92186581NANA 4535Carrier 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 cm10238.92186581NANA 4536Carrier 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 approach10238.92186581NANA 4537Carrier 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.100.0875000021NANA 4538Carrier J2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0018Alcohol And/Or Drug Services100.08719639851.213NANA 4539Carrier 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.100.0875000021NANA 4540Carrier 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; individual2380.611.16689083349.71417048208812371NANA 4541Carrier 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)2320.932.809104673232NANA 4542Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services204113.4194950914.005359173201NANA 4543Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours1150.9140.940329115NANA 4544Carrier 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 session1040.9328.8476640636.9558035434805991NANA 4545Carrier 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 management1040.9335.4324786837.279013754100NANA 4546Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem910.9718.2841666726.99379394190NANA 4547Carrier 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 management780.9538.7977493535.17500741375NANA 4548Carrier 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 minutes530.637.9968515853NANA 4549Carrier J2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain440.982.59833333344NANA 4550Carrier 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);8118.127668788NANA 4551Carrier 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 abnormalities719.8271286972071NANA 4552Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450CT, head or brain wo contrast410.0315277784NANA 4553Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction4142.58276164NANA 4554Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT41899Unlisted procedure, dentoalveolar structures3143.046680553NANA 4555Carrier 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)3132.246909263NANA 4556Carrier 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 modification3128.349682393NANA 4557Carrier 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 analysis3132.246909263NANA 4558Carrier 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)21150.15662922NANA 4559Carrier J2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes2154.460040282NANA 4560Carrier 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)212949.9051312NANA 4561Carrier 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 approach21173.16598332NANA 4562Carrier 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) alleles2112.3662572021NANA 4563Carrier 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]36450.961.854224334144036452NANA 4564Carrier 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)18710.342040998187NANA 4565Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate1020.9920.492777780.210775487221001NANA 4566Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos260.2719.5073055644.5256387125NANA 4567Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi260.2782.6006443726NANA 4568Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine150.2142.587637215NANA 4569Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable150.333.796158334117.8163427114NANA 4570Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq1300.2164899313NANA 4571Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor110.0996.5561868711NANA 4572Carrier J2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate1000.62238478410NANA 4573Carrier 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)18710.342040998187NANA 4574Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861PWC gp 3 std mult pow opt s/b3123.048903433NANA 4575Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0856PWC gp 3 std sing pow opt s/b111NANA 4576Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate1020.9920.492777780.210775487221001NANA 4577Carrier 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]36450.961.854224334144036452NANA 4578Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal50.686.140786675NANA 4579Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified20.510.07501572NANA 4580Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable150.333.796158334117.8163427114NANA 4581Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos260.2719.5073055644.5256387125NANA 4582Carrier J2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi260.2782.6006443726NANA 4583Carrier J2022DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0748Elec Osteogen Stim Spinal50.286.140786675NANA 4584Carrier 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]364501.854224334144036452NANA 4585Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin840.9627.22983188624841NANA 4586Carrier 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 system700.8005138497NANA 4587Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc7011.985676397NANA 4588Carrier 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 supply600.9196027326NANA 4589Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl6013.350627616NANA 4590Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml500.0698048335NANA 4591Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4253Blood Glucose/Reagent Strips105.1609555551NANA 4592Carrier J2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.0059000021NANA 4593Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin840.9627.22983188624841NANA 4594Carrier 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 system700.8005138497NANA 4595Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc7011.985676397NANA 4596Carrier 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 supply600.9196027326NANA 4597Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl6013.350627616NANA 4598Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml500.0698048335NANA 4599Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4253Blood Glucose/Reagent Strips105.1609555551NANA 4600Carrier J2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4231Infusion Insulin Pump Needle100.0059000021NANA 4601Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6730.7778.854170503ADALIMUMABNA 4602Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4100.69510.846.334376CYCLOSPORINE (OPHTH)NA 4603Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3530.01110.747.5154199INSULIN GLARGINENA 4604Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2980.0741451.665233TIRZEPATIDENA 4605Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2950.5199.8134.8129166OXYCODONE HCLNA 4606Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2800.68922.492.884196GALCANEZUMAB-GNLMNA 4607Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2770.53415.4127.690187HYDROCODONE-ACETAMINOPHENNA 4608Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2660.33128.363.851215DUPILUMABNA 4609Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2450.0048.148.444201SEMAGLUTIDENA 4610Carrier J2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2390.778.434.148191ETANERCEPTNA 4611Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA711.734.725TAFLUPROSTNA 4612Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA618.260OSIMERTINIB MESYLATENA 4613Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5112.327.441DABRAFENIB MESYLATENA 4614Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5114.628.914TERIPARATIDE (RECOMBINANT)NA 4615Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511.869.441IBRUTINIBNA 4616Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3110.82.921ANAKINRANA 4617Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2120.620NINTEDANIB ESYLATENA 4618Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2127.720REGORAFENIBNA 4619Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2148.402ABALOPARATIDENA 4620Carrier J2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1150.901DEUCRAVACITINIBNA 4621Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3122.524.511ALPELISIBNA 4622Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA7112.720TRAMETINIB DIMETHYL SULFOXIDENA 4623Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA31154.102INSULIN GLULISINENA 4624Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.6673.2187.811ABEMACICLIBNA 4625Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA80.667157.102SARILUMABNA 4626Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1820.52.910RISANKIZUMAB-RZAANA 4627Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1340.51.6238.611APREMILASTNA 4628Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA320.52.410PALBOCICLIBNA 4629Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA160.515.910INSULIN REGULAR (HUMAN)NA 4630Carrier J2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA120.5150.101SOFOSBUVIR-VELPATASVIRNA 4631Carrier 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)500.0848138425NANA 4632Carrier 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)5120.465835625NANA 4633Carrier I2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9100Cytarabine Hcl 100 Mg Inj400.0606054NANA 4634Carrier 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 age412.433759.76639819422NANA 4635Carrier 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)400.0842857224NANA 4636Carrier 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.302.1102333340.04742041712NANA 4637Carrier 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)302.1102333340.04750180612NANA 4638Carrier 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/drug302.1102333340.04744958412NANA 4639Carrier 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; lumbar3124.862173763NANA 4640Carrier 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)3121.493932723NANA 4641Carrier 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; meningioma300.0829163893NANA 4642Carrier 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)5120.465835625NANA 4643Carrier 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 age412.433759.76639819422NANA 4644Carrier 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; lumbar3124.862173763NANA 4645Carrier 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)3121.493932723NANA 4646Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49560Repair initial incisional or ventral hernia; reducible21121.27634032NANA 4647Carrier 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)211.4150370382NANA 4648Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor116.4022222231NANA 4649Carrier 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 allograft1119.004416671NANA 4650Carrier 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); lumbar112.1010277781NANA 4651Carrier 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; allogeneic116.4022222231NANA 4652Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44238Unlisted laparoscopy procedure, intestine (except rectum)11145.43294171NANA 4653Carrier 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)111.1747222231NANA 4654Carrier 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)112.1010277781NANA 4655Carrier 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); reducible1114.828402781NANA 4656Carrier 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)1126.495256391NANA 4657Carrier 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)1126.495256391NANA 4658Carrier 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)110.0430555561NANA 4659Carrier 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 segment1123.815384171NANA 4660Carrier 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, lumbar1126.495256391NANA 4661Carrier 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; cervical110.0430555561NANA 4662Carrier 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; lumbar112.1010277781NANA 4663Carrier 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)112.1010277781NANA 4664Carrier I2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63200Laminectomy, with release of tethered spinal cord, lumbar1123.003018611NANA 4665Carrier 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 C2110.0430555561NANA 4666Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis1860.913.457180484721861NANA 4667Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete1850.935.466368528185NANA 4668Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr1680.7411.37845238168NANA 4669Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1350.936.37458534620161351NANA 4670Carrier 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 saturation1220.94.890858175122NANA 4671Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1150.798.11394349524001151NANA 4672Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250DIAGNOSTIC CT THORAX W/O CNTRST850.913.86500308785NANA 4673Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI, any joint of upper extremity; wo co780.7611.3461077678NANA 4674Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain660.857.23077294766NANA 4675Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93307ECHO, transthoracic, heart, complete640.9710.2014603264NANA 4676Carrier I2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260DIAGNOSTIC CT THORAX W/CONTRAST640.951.65082491664NANA 4677Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70491Contrast CAT scan of neck tissue1917.88334795319NANA 4678Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74177CT abd & pelv w contrast1710.02807098817NANA 4679Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70544MRA, head, w/o contrast1215.51993589712NANA 4680Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1112.2833838382016111NANA 4681Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr8115.972777788NANA 4682Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73223MRI upr ext jnt w/o cntrst flwd cnt7114.353492067NANA 4683Carrier 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 specifications717.4702599332.8047406952NANA 4684Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29827Arthroscopy, shoulder, surgical; with rotator cuff repair718.094536684252071NANA 4685Carrier I2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74181MRI, abdomen; wo contrast material(s)7111.346354177NANA 4686Carrier 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)714.0214600397NANA 4687Carrier 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 si7114.40305817NANA 4688Carrier 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 plan717.4702599332.8047406952NANA 4689Carrier I2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93350Stress ECHO exam of heart250.0417.448525NANA 4690Carrier 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/CAD390.0310.8236805639NANA 4691Carrier 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 co780.0111.3461077678NANA 4692Carrier 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 sequences1350.016.37458534620161351NANA 4693Carrier 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 contr1680.0111.37845238168NANA 4694Carrier I2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder18131.5564857618NANA 4695Carrier I2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric5163.935833335NANA 4696Carrier I2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric311.97194444512.6339226412NANA 4697Carrier I2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder18131.5564857618NANA 4698Carrier I2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric5163.935833335NANA 4699Carrier I2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric311.97194444512.6339226412NANA 4700Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12183.1343867112NANA 4701Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem11126.9778469411NANA 4702Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction6118.368542736NANA 4703Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete6118.368542136NANA 4704Carrier 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 management5125.5847222212.4467822214NANA 4705Carrier 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 session5125.5847222212.4467822214NANA 4706Carrier 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 management5125.5847222212.4467810414NANA 4707Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours50.836.597357945NANA 4708Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences410.0002083334NANA 4709Carrier 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)210.0002777762NANA 4710Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue20.545.863537922NANA 4711Carrier I2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318Breast reduction21123.18426192NANA 4712Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services12183.1343867112NANA 4713Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem11126.9778469411NANA 4714Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction6118.368542736NANA 4715Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete6118.368542136NANA 4716Carrier 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 management5125.5847222212.4467822214NANA 4717Carrier 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 session5125.5847222212.4467822214NANA 4718Carrier 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 management5125.5847222212.4467810414NANA 4719Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences410.0002083334NANA 4720Carrier 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)210.0002777762NANA 4721Carrier I2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction21123.18426192NANA 4722Carrier 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]2810.951.995146947281NANA 4723Carrier 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)190.896.46160818719NANA 4724Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos50.481.358090175NANA 4725Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate410.0001388894NANA 4726Carrier 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 hardware3023.187570653NANA 4727Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq3021.676033333NANA 4728Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each3023.187530283NANA 4729Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi3040.8443305661.4739236112NANA 4730Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in2032.472398612NANA 4731Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in200.0442634722NANA 4732Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B2034.778370832NANA 4733Carrier I2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware2032.472452782NANA 4734Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate410.0001388894NANA 4735Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor11133.95138891NANA 4736Carrier 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]2810.951.995146947281NANA 4737Carrier 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)190.896.46160818719NANA 4738Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos50.481.358090175NANA 4739Carrier 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 hardware3023.187570653NANA 4740Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq3021.676033333NANA 4741Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each3023.187530283NANA 4742Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi3040.8443305661.4739236112NANA 4743Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin pro/pos wc cus wd <22in2032.472398612NANA 4744Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in200.0442634722NANA 4745Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B2034.778370832NANA 4746Carrier I2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware2032.472452782NANA 4747Carrier I2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin120.580.61408055526.50367164111NANA 4748Carrier I2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin120.580.61408055526.50367164111NANA 4749Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA390.8462.160.7930ADALIMUMABNA 4750Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2603.813.6521RIMEGEPANT SULFATENA 4751Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA250.82128124CYCLOSPORINE (OPHTH)NA 4752Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA210.8575.836.1516ETANERCEPTNA 4753Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA200.2521.245.2911RIFAXIMINNA 4754Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA200.66.2554.9317RISANKIZUMAB-RZAANA 4755Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA180.27821.636.2414DUPILUMABNA 4756Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA180.523.9142711HYDROCODONE-ACETAMINOPHENNA 4757Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA170.70645.252.5116GALCANEZUMAB-GNLMNA 4758Carrier I2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1601.112.3115UBROGEPANTNA 4759Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8140.108LIFITEGRASTNA 4760Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6113.506GUSELKUMABNA 4761Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA319.725.821MORPHINE SULFATENA 4762Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA315603LEVALBUTEROL TARTRATENA 4763Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3141.103ELEXACAFTOR-TEZACAFTOR-IVACAFTORNA 4764Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA212.266.611HYDROCODONE BITARTRATENA 4765Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA21613.902TERIPARATIDE (RECOMBINANT)NA 4766Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2123.302ALIROCUMABNA 4767Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1164.601TUCATINIBNA 4768Carrier I2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1145.201FENTANYLNA 4769Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3119.510TOCILIZUMABNA 4770Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1144.210IVABRADINE HCLNA 4771Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.52.210ABEMACICLIBNA 4772Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA170.252.210GALCANEZUMAB-GNLMNA 4773Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA180.224.301HYDROCODONE-ACETAMINOPHENNA 4774Carrier I2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA200.1329.701RIFAXIMINNA 4775Carrier 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)70.712.79134805470.3900182216NANA 4776Carrier 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)70.862.791348054111.048635916NANA 4777Carrier 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); lumbar60.832.79134805477.4588196215NANA 4778Carrier 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; lumbar512.791348054117.043052214NANA 4779Carrier 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)512.79134805478.137382914NANA 4780Carrier 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 performed4018.412370424NANA 4781Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44620Closure of enterostomy, large or small intestine;400.08691250.761622NANA 4782Carrier 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 segments30.6769.376399173NANA 4783Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS2068Breast DIEP flag reconstruct300.0865222220.78575138812NANA 4784Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11971Removal of tissue expander without insertion of implant300.08661750.78851208212NANA 4785Carrier A2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43280Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)30.67139.35759473NANA 4786Carrier 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)300.0801277780.76477777812NANA 4787Carrier 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)30.6749.17061653NANA 4788Carrier 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)300.0865611120.7857986112NANA 4789Carrier 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; lumbar512.791348054117.043052214NANA 4790Carrier 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)512.79134805478.137382914NANA 4791Carrier 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)212.791348054289.312018611NANA 4792Carrier 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 component11115.27178141NANA 4793Carrier 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 component11115.27178141NANA 4794Carrier 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 protection110.6949999991NANA 4795Carrier 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, lumbar1193.066944441NANA 4796Carrier 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)1197.462759171NANA 4797Carrier 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; lumbar11289.31201861NANA 4798Carrier 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; cervical11103.87294811NANA 4799Carrier 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; cervical110.1380555551NANA 4800Carrier 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)11289.31201861NANA 4801Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion1197.462759171NANA 4802Carrier 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); radiofrequency110.0151NANA 4803Carrier 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)11101.65521751NANA 4804Carrier A2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49565Repair recurrent incisional or ventral hernia; reducible1118.589444441NANA 4805Carrier 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)110.1380555551NANA 4806Carrier 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 flexibility3760.716.86832128403762NANA 4807Carrier 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 minutes3710.7116.560136269603711NANA 4808Carrier 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 minutes2750.6719.318187527202751NANA 4809Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2630.97.54533625745362631NANA 4810Carrier 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 activities2360.6319.745511187202361NANA 4811Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr2350.8920.662222225.89100226896012341NANA 4812Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74176CT abd & pelvis2170.920.0727777786.737107843163212161NANA 4813Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1510.848.820283224151NANA 4814Carrier A2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1360.954.436449716136NANA 4815Carrier 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 saturation1350.974.253513072135NANA 4816Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72156MRI of cervical spine2811.57593518528NANA 4817Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1710.03767973917NANA 4818Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng1612.66786458416NANA 4819Carrier 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 si15157.9162269415NANA 4820Carrier 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)11118.94451811NANA 4821Carrier 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 plan1110.9854166667.28447666729NANA 4822Carrier 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 specifications1010.9852777787.87430694528NANA 4823Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70480CT, orbit, sella or pos fos wo contrast1011.97855555510NANA 4824Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70498CTA, neck, w/o cntrst flwd by cntrst1013.70741666710NANA 4825Carrier A2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr1016.89338888910NANA 4826Carrier A2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8614Cochlear implant system11674.53638891NANA 4827Carrier 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 mastoidectomy11674.53638891NANA 4828Carrier 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 contr2350.0120.662222225.89100226896012341NANA 4829Carrier A2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine1510.018.820283224151NANA 4830Carrier A2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder3131.808425933NANA 4831Carrier A2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services1011.980461111NANA 4832Carrier A2022Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA 4833Carrier A2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder3131.808425933NANA 4834Carrier A2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0011Alcohol And/Or Drug Services1011.980461111NANA 4835Carrier A2022Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric10138.84166671NANA 4836Carrier 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)320.884.85801215332NANA 4837Carrier 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; individual150.630.6546724415NANA 4838Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services80.8820.658610289.89624960317NANA 4839Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain40.7512.011458334NANA 4840Carrier 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 management40.542.9002777856.5798099113NANA 4841Carrier 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 session40.542.9002777856.579902513NANA 4842Carrier 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 management30.6742.9002777823.6173537512NANA 4843Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours3144.394537043NANA 4844Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834Psychotherapy, 45 minutes with patient2025.087069032NANA 4845Carrier 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 minutes2144.204902782NANA 4846Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem2114.2341666714.6894444411NANA 4847Carrier 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)2025.087069032NANA 4848Carrier A2022Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90847Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes2025.087069032NANA 4849Carrier 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 exercises2144.204902782NANA 4850Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours3144.394537043NANA 4851Carrier 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 minutes2144.204902782NANA 4852Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem2114.2341666714.6894444411NANA 4853Carrier 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 exercises2144.204902782NANA 4854Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9131Physical therapy, in the home, per diem110.4429305551NANA 4855Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450CT, head or brain wo contrast1101NANA 4856Carrier 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)320.884.85801215332NANA 4857Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services80.8820.658610289.89624960317NANA 4858Carrier A2022Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain40.7512.011458334NANA 4859Carrier 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 management30.6742.9002777823.6173537512NANA 4860Carrier 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]2450.942.69965873245NANA 4861Carrier 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)1410.04162698414NANA 4862Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate80.883.3449305558NANA 4863Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable50.468.24032855NANA 4864Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal40.540.27916254NANA 4865Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi30130.25263893NANA 4866Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos3052.960211673NANA 4867Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine3048.992962963NANA 4868Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor30129.17666673NANA 4869Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate202.3620908342NANA 4870Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi202.3620908342NANA 4871Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension202.3620908342NANA 4872Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B202.3623686112NANA 4873Carrier 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 wheels203.2692073622NANA 4874Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each202.3623686112NANA 4875Carrier A2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware202.3622297232NANA 4876Carrier 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)1410.04162698414NANA 4877Carrier 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]2450.942.69965873245NANA 4878Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate80.883.3449305558NANA 4879Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal40.540.27916254NANA 4880Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable50.468.24032855NANA 4881Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi30130.25263893NANA 4882Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos3052.960211673NANA 4883Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine3048.992962963NANA 4884Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor30129.17666673NANA 4885Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate202.3620908342NANA 4886Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0971Wheelchair Anti-Tipping Devi202.3620908342NANA 4887Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0961Wheelchair Brake Extension202.3620908342NANA 4888Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair Belt W/Airplane B202.3623686112NANA 4889Carrier 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 wheels203.2692073622NANA 4890Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each202.3623686112NANA 4891Carrier A2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware202.3622297232NANA 4892Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin10114.0148223110NANA 4893Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl301.1945206483NANA 4894Carrier A2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc301.1945308343NANA 4895Carrier 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 system200.0863305572NANA 4896Carrier 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 supply200.0863652782NANA 4897Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin10114.0148223110NANA 4898Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl301.1945206483NANA 4899Carrier A2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc301.1945308343NANA 4900Carrier 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 system200.0863305572NANA 4901Carrier 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 supply200.0863652782NANA 4902Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA680.85312.639.2860ADALIMUMABNA 4903Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA500.682533.6347CYCLOSPORINE (OPHTH)NA 4904Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA470.8519.226.62027INSULIN GLARGINENA 4905Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA310.5819.954.2526HYDROCODONE-ACETAMINOPHENNA 4906Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA270.7045.7136.11512OXYCODONE W/ ACETAMINOPHENNA 4907Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA250.3210.598.4322EVOLOCUMABNA 4908Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA25022.748.4124TIRZEPATIDENA 4909Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.7513.263.2420GALCANEZUMAB-GNLMNA 4910Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.7081.434.4420ETANERCEPTNA 4911Carrier A2022Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA220.27338.822.9616DUPILUMABNA 4912Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA412.923.613FENTANYLNA 4913Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3115.957.712LIFITEGRASTNA 4914Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA312.430ACALABRUTINIB MALEATENA 4915Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2186.602MAVACAMTENNA 4916Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA211.920CANNABIDIOLNA 4917Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2117.319.711CANAGLIFLOZIN-METFORMIN HCLNA 4918Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2131.802INSULIN ASPART (WITH NIACINAMIDE)NA 4919Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2116.14511ABALOPARATIDENA 4920Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA21309.402ELAGOLIX SODIUMNA 4921Carrier A2022Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2156.702TERIPARATIDE (RECOMBINANT)NA 4922Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11222.910SELEXIPAGNA 4923Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA115.310GLYCOPYRRONIUM TOSYLATENA 4924Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1123.910ANAKINRANA 4925Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA240.66783.802GALCANEZUMAB-GNLMNA 4926Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA130.5234.601ERENUMAB-AOOENA 4927Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA500.167141.801CYCLOSPORINE (OPHTH)NA 4928Carrier A2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA250.15425.1312.611EVOLOCUMABNA 4929Carrier 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 maintenance50.2151.705NANA 4930Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap�4149.204NANA 4931Carrier 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 performed4169.604NANA 4932Carrier 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)4176.604NANA 4933Carrier 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)40189.504NANA 4934Carrier L2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38571Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy3192.603NANA 4935Carrier 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)31379.803NANA 4936Carrier 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�2114.202NANA 4937Carrier 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 thoracoscopy20131.202NANA 4938Carrier 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 unilateral2122.7143.511NANA 4939Carrier 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 approach20.567.3134.211NANA 4940Carrier 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 approach20.583.111NANA 4941Carrier 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 multiple21490.302NANA 4942Carrier 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)21490.302NANA 4943Carrier 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)�21102.102NANA 4944Carrier 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)2195.602NANA 4945Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap�4149.204NANA 4946Carrier 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 performed4169.604NANA 4947Carrier 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)4176.604NANA 4948Carrier L2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38571Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy3192.603NANA 4949Carrier 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)31379.803NANA 4950Carrier 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�2114.202NANA 4951Carrier 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 unilateral2122.7143.511NANA 4952Carrier 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 multiple21490.302NANA 4953Carrier 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)21490.302NANA 4954Carrier 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)�21102.102NANA 4955Carrier 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)2195.602NANA 4956Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple2650.8426.435.82263NANA 4957Carrier 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)2640.8232.437.23261NANA 4958Carrier 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�2190.8452.539.81218NANA 4959Carrier 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 forceps1290.8219.32129NANA 4960Carrier 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)9110.12.8190NANA 4961Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple9010.12.2387NANA 4962Carrier L2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure870.9120.287NANA 4963Carrier 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 technologist580.556258NANA 4964Carrier 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 risk530.752.526.6152NANA 4965Carrier 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 technologist430.515543NANA 4966Carrier 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)9110.12.8190NANA 4967Carrier L2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple9010.12.2387NANA 4968Carrier 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)2610.11.9125NANA 4969Carrier 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 wire2511.825NANA 4970Carrier 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)�2310.20.11013NANA 4971Carrier 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 organism2210.222NANA 4972Carrier 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 C2119.32.9219NANA 4973Carrier 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)18112.818NANA 4974Carrier 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)1619.116NANA 4975Carrier 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 technique1410.214NANA 4976Carrier 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)1410.20.2311NANA 4977Carrier 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 organism1410.214NANA 4978Carrier 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 colon21228020NANA 4979Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTF64.9Gender identity disorder, unspecified11240010NANA 4980Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTM26.6Temporomandibular joint disorders11456010NANA 4981Carrier 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 region11312010NANA 4982Carrier 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 uterus11336010NANA 4983Carrier 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 ovaries11336010NANA 4984Carrier 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, unspecified11336010NANA 4985Carrier L2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTR41.83Borderline intellectual functioning11696010NANA 4986Carrier 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 classified11648010NANA 4987Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis stimulator, low intensity ultrasound, non-invasive40.540.204NANA 4988Carrier 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 accessory3097.303NANA 4989Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable3192.803NANA 4990Carrier 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 adjustment2181.802NANA 4991Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis stimulator, electrical, noninvasive, other than spinal applications2010302NANA 4992Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications2113.402NANA 4993Carrier 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, each2197.302NANA 4994Carrier L2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1002Wheelchair accessory, power seating system, tilt only2185.702NANA 4995Carrier 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�2157.802NANA 4996Carrier 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, each219502NANA 4997Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable3192.803NANA 4998Carrier 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 adjustment2181.802NANA 4999Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications2113.402NANA 5000Carrier 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�2157.802NANA 5001Carrier 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, each219502NANA 5002Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair accessory, positioning belt/safety belt/pelvic strap, each114901NANA 5003Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1802Dynamic adjustable forearm pronation/supination device, includes soft interface material�110.101NANA 5004Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1805Dynamic adjustable wrist extension / flexion device, includes soft interface material�110.101NANA 5005Carrier 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 access117.401NANA 5006Carrier L2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005Ultralightweight wheelchair�114901NANA 5007Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA714.0611.04430STELARA INJ 90MG/MLNA 5008Carrier 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/MLNA 5009Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.810.91040TALTZ INJ 80MG/MLNA 5010Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA90.443.4710.32130DUPIXENT INJ 300/2MLNA 5011Carrier 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 ODTNA 5012Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA317.25030AIMOVIG INJ 140MG/MLNA 5013Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA212.6111.15110AJOVY INJ 225/1.5NA 5014Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA219.9020OZEMPIC INJ 4MG/3MLNA 5015Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA219.4020ENTRESTO TAB 24-26MGNA 5016Carrier L2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA216.87020DUPIXENT INJ 200MGNA 5017Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin8159.808NANA 5018Carrier 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 service40.525.937.113NANA 5019Carrier 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�30.3325.943.812NANA 5020Carrier 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 accessories212371.711NANA 5021Carrier 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 supply20.5109.902NANA 5022Carrier L2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor212371.711NANA 5023Carrier 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)1195.801NANA 5024Carrier 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)1195.801NANA 5025Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin8159.808NANA 5026Carrier 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 accessories212371.711NANA 5027Carrier L2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor212371.711NANA 5028Carrier 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)1195.801NANA 5029Carrier 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)1195.801NANA 5030Carrier 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 service40.525.937.113NANA 5031Carrier 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 supply20.5109.902NANA 5032Carrier 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�30.3325.943.812NANA 5033Carrier 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 COMPLICATIONS40.51.518.6111NANA 5034Carrier 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 COMPLICATIONS40.251.5910NANA 5035Carrier 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);50.80.358.414NANA 5036Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap3143.953NANA 5037Carrier 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�21422NANA 5038Carrier 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-aortic20.590.12NANA 5039Carrier 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)�20.590.12NANA 5040Carrier K2022Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49255Omentectomy, epiploectomy, resection of omentum (separate procedure)20.590.12NANA 5041Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap3143.953NANA 5042Carrier 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�21422NANA 5043Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15770Graft; derma-fat-fascia1145.91NANA 5044Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21615Excision first and/or cervical rib11124.21NANA 5045Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21705Division of scalenus anticus; with resection of cervical rib11124.21NANA 5046Carrier 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)118.41NANA 5047Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32100Thoracotomy; with exploration118.41NANA 5048Carrier 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), unilateral118.41NANA 5049Carrier 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)1145.91NANA 5050Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT39200Resection of mediastinal cyst118.41NANA 5051Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45400Laparoscopy, surgical; proctopexy (for prolapse)11981NANA 5052Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57250Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy11981NANA 5053Carrier 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)�11981NANA 5054Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57425Laparoscopy, surgical, colpopexy (suspension of vaginal apex)�11981NANA 5055Carrier 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)11981NANA 5056Carrier 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)�1198.41NANA 5057Carrier 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�1190.71NANA 5058Carrier 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)1190.71NANA 5059Carrier 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�1148.11NANA 5060Carrier 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)�1148.11NANA 5061Carrier 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.1190.71NANA 5062Carrier K2022Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTC1771Repair device, urinary, incontinence, with sling graft11981NANA 5063Carrier K2022Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTQ67.6Pectus excavatum111248010NANA 5064Carrier 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)1300.8149.422.75125NANA 5065Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1200.8249.419.95115NANA 5066Carrier 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 technique1110.8149.420.74107NANA 5067Carrier 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 forceps580.7624.958NANA 5068Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure530.9212.953NANA 5069Carrier 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)350.910.210.4134NANA 5070Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple350.910.28.4134NANA 5071Carrier 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 technologist350.7142.5114.6134NANA 5072Carrier 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 risk270.724.532.3334NANA 5073Carrier 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 technologist240.67145.924NANA 5074Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499Chiropractic Care2370.996237NANA 5075Carrier K2022Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499Therapy Care3890.982389NANA 5076Carrier 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)15113.4015NANA 5077Carrier 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 wire1310.211.3112NANA 5078Carrier 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 2112110.3012NANA 5079Carrier 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)1010.158.928NANA 5080Carrier 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)�1010.35010NANA 5081Carrier 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)912.309NANA 5082Carrier 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�910.1409NANA 5083Carrier 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 technique810.20.1417NANA 5084Carrier 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)�8127.962.117NANA 5085Carrier 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)710.20.1316NANA 5086Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81401MOLECULAR PATHOLOGY PROCEDURE LEVEL 2710.1107NANA 5087Carrier 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 score712.8707NANA 5088Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499Chiropractic Care2370.996237NANA 5089Carrier K2022Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499Therapy Care3890.982389NANA 5090Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTF64.9Gender identity disorder, unspecified10.5264020NANA 5091Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG47.30Sleep apnea, unspecified11336010NANA 5092Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTI47.1Supraventricular tachycardia11360010NANA 5093Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTM26.02Maxillary hypoplasia11336010NANA 5094Carrier 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 region11240010NANA 5095Carrier K2022Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTR07.9Chest pain, unspecified112448010NANA 5096Carrier 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 colon11336010NANA 5097Carrier 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 type410.681.913NANA 5098Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous3070.93NANA 5099Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8614Cochlear device, includes all internal and external components20165.12NANA 5100Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4087Gastrostomy/jejunostomy tube, standard, any material, any type, each11167.51NANA 5101Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4088Gastrostomy/jejunostomy tube, low-profile, any material, any type, each11167.51NANA 5102Carrier 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 unit11167.51NANA 5103Carrier 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 unit11167.51NANA 5104Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0642Standing frame/table system, mobile (dynamic stander), any size including pediatric1170.91NANA 5105Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1805Dynamic adjustable wrist extension / flexion device, includes soft interface material110.21NANA 5106Carrier 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 only114.11NANA 5107Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8615Headset/headpiece for Use with cochlear implant device, replacement1125.11NANA 5108Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8616Microphone for Use with cochlear implant device, replacement1125.11NANA 5109Carrier K2022DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8619Cochlear implant, external speech processor and controller, integrated system, replacement1125.11NANA 5110Carrier 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, each1125.11NANA 5111Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4087Gastrostomy/jejunostomy tube, standard, any material, any type, each11167.51NANA 5112Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4088Gastrostomy/jejunostomy tube, low-profile, any material, any type, each11167.51NANA 5113Carrier 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 unit11167.51NANA 5114Carrier 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 unit11167.51NANA 5115Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0642Standing frame/table system, mobile (dynamic stander), any size including pediatric1170.91NANA 5116Carrier 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 type410.681.913NANA 5117Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1805Dynamic adjustable wrist extension / flexion device, includes soft interface material110.21NANA 5118Carrier 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 only114.11NANA 5119Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8615Headset/headpiece for Use with cochlear implant device, replacement1125.11NANA 5120Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8616Microphone for Use with cochlear implant device, replacement1125.11NANA 5121Carrier K2022DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear implant, external speech processor and controller, integrated system, replacement1125.11NANA 5122Carrier 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, each1125.11NANA 5123Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin40.552.44NANA 5124Carrier 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 accessories1139.91NANA 5125Carrier K2022Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1139.91NANA 5126Carrier 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 service1045.21NANA 5127Carrier 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 system1045.21NANA 5128Carrier 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 accessories1139.91NANA 5129Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0607Home blood glucose monitor1139.91NANA 5130Carrier K2022Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin40.552.44NANA 5131Carrier 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 service1045.21NANA 5132Carrier 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 system1045.21NANA 5133Carrier 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 COMPLICATIONS60.8310.2205NANA 5134Carrier 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 COMPLICATIONS2113.5702NANA 5135Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA130.922.449.481110DUPIXENT INJ 300/2MLNA 5136Carrier 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/MLNA 5137Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA911.910.5360EMGALITY INJ 120MG/MLNA 5138Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA819.1080XIFAXAN TAB 550MGNA 5139Carrier 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/MLNA 5140Carrier 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/MLNA 5141Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA70.578.54040TALTZ INJ 80MG/MLNA 5142Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA413.1810.75310AIMOVIG INJ 140MG/MLNA 5143Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA50.82.5711.52130HUMIRA INJ 40/0.4MLNA 5144Carrier K2022Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA60.511.76030UBRELVY TAB 100MGNA 5145Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST10117.84466667010NANA 5146Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED80.25143.223506908NANA 5147Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY7118.9730952407NANA 5148Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY7192.3947222211.4947222216NANA 5149Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45330SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS5124.0957222205NANA 5150Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG50.863.41777778123.353055614NANA 5151Carrier 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 TH50.625.8894444405NANA 5152Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS417.77916666704NANA 5153Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT40.2555.8480555604NANA 5154Carrier M2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION40.588.1431944404NANA 5155Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST10117.84466667010NANA 5156Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY7192.3947222211.4947222216NANA 5157Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY7118.9730952407NANA 5158Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45330SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS5124.0957222205NANA 5159Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58140MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR4121.9934027804NANA 5160Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614ARTHRD PST TQ 1NTRSPC EA ADD41122.229930604NANA 5161Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS417.77916666704NANA 5162Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0185INJ., APREPITANT, 1 MG31150.800370403NANA 5163Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405RPLCMT PROST AORTIC VALVE XCP HOMOGRF/STENT311.11194444413.4048611112NANA 5164Carrier M2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55866LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT316.4897222222.68930555612NANA 5165Carrier 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 MORSELIZED80.25143.223506908NANA 5166Carrier 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 SEG50.863.41777778123.353055614NANA 5167Carrier 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 INCISION40.588.1431944404NANA 5168Carrier 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/ALGRFT40.2555.8480555604NANA 5169Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633ARTHRD CMBN 1NTRSPC LUMBAR40.2563.3955555677.2976851913NANA 5170Carrier M2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22840POSTERIOR NON-SEGMENTAL INSTRUMENTATION30.3333114.556851903NANA 5171Carrier 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 CM20.570.2577777852.6113888911NANA 5172Carrier 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 STRUCTURAL1025.3463888901NANA 5173Carrier 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 SEG10161.641944401NANA 5174Carrier 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 SEG10161.675277801NANA 5175Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585Botox2120.8963316196NANA 5176Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCQ5103Inflectra1110.9529473279NANA 5177Carrier 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 ENDOSCO621431.38857013161NANA 5178Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ3380Entyvio570.9816591146NANA 5179Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ7323Euflexxa520.850.360151NANA 5180Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0178Eylea500.922754842NANA 5181Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9217Lupron Depot/eligard470.8316451136NANA 5182Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30520SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF400.852.8568125040NANA 5183Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT89253ASSTD EMBRYO HATCHING MICROTQS ANY METH400.55140.8267361040NANA 5184Carrier M2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS390.666731.19041311039NANA 5185Carrier 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 ENDOSCO621431.38857013161NANA 5186Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2350Ocrevus2911642722NANA 5187Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C19119.11361111135.8474074118NANA 5188Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN19137.16324561019NANA 5189Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2777Vabysmo161629214NANA 5190Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000CYSTOURETHROSCOPY (SEPARATE PROCEDURE)12172.62516204012NANA 5191Carrier 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 FIXATION11157.66227273011NANA 5192Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99354PROLNG SVC O/P 1ST HOUR10133.8973611153.605937528NANA 5193Carrier 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, REQUIR10114.24536111010NANA 5194Carrier M2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9299Opdivo101242246NANA 5195Carrier 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 METH400.55140.8267361040NANA 5196Carrier 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 COMPARTMENTS390.666731.19041311039NANA 5197Carrier 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/ALGRFT380.789558.55517544038NANA 5198Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89258CRYOPRSRV EMBRYO270.6296131.0831276027NANA 5199Carrier 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)230.6522106.5142633023NANA 5200Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS4011IVF PACKAGE220.5105.7116667022NANA 5201Carrier 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 SINUS210.47621.89527777864.18061111120NANA 5202Carrier 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 EXPLORATION200.559.72013888992.69424383218NANA 5203Carrier 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 TOTAL90.444497.5266666709NANA 5204Carrier M2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER70.571453.7523015907NANA 5205Carrier M2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY250.9226.8391666712.8031746421NANA 5206Carrier M2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY9111.3697222214.95245NANA 5207Carrier M2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADETOXIFICATION110.09361111101NANA 5208Carrier M2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY9111.3697222214.95245NANA 5209Carrier M2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADETOXIFICATION110.09361111101NANA 5210Carrier M2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY250.9226.8391666712.8031746421NANA 5211Carrier M2023Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMENTAL HEALTH RESIDENTIAL TREATMENT FACILITY250.9226.8391666712.8031746421NANA 5212Carrier M2023Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANACHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY9111.3697222214.95245NANA 5213Carrier M2023Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANADETOXIFICATION110.09361111101NANA 5214Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT501839.5197833050NANA 5215Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN450.9556130.0407222045NANA 5216Carrier 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 MIN420.9286158.0830952042NANA 5217Carrier 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 MIN420.9524155.3306085042NANA 5218Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN390.9744163.1087892039NANA 5219Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H3319.80180555665.04741936231NANA 5220Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH2036A/D TX PROGRAM, PER DIEM210.952481.1856944428.45656433219NANA 5221Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG130.6923312.391047013NANA 5222Carrier M2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY, 45 MINUTES WITH PATIENT1211.03583333322.5030303111NANA 5223Carrier 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&M120.6667331.9065972012NANA 5224Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT501839.5197833050NANA 5225Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H3319.80180555665.04741936231NANA 5226Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY, 45 MINUTES WITH PATIENT1211.03583333322.5030303111NANA 5227Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION91103.969475309NANA 5228Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES5110.9131111105NANA 5229Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT311645.73907403NANA 5230Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99215OFFICE O/P EST HI 40-54 MIN3184.9692592603NANA 5231Carrier 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 MINUT31431.151296303NANA 5232Carrier M2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90846FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT212292.117502NANA 5233Carrier 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)2146.7334722202NANA 5234Carrier 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 MIN450.9556130.0407222045NANA 5235Carrier 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 MIN420.9524155.3306085042NANA 5236Carrier 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 MIN420.9286158.0830952042NANA 5237Carrier 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 & MNG130.6923312.391047013NANA 5238Carrier 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&M120.6667331.9065972012NANA 5239Carrier M2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90832PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES5110.9131111105NANA 5240Carrier 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 MIN40.7529.3797222204NANA 5241Carrier 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 HOUR1021.647501NANA 5242Carrier 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 MIN10115.611944401NANA 5243Carrier 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 MIN10119.219444401NANA 5244Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0486ORAL DEVICE/APPLIANCE CUSFAB2059.6704166702NANA 5245Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5845KNEE-SHIN SYS STANCE FLEXION1128.2630555601NANA 5246Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.1977777801NANA 5247Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5968MULTIAXIAL ANKLE W DORSIFLEX1121.8994444401NANA 5248Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5652SUCTION SUSP AK/KNEE DISART1128.2511111101NANA 5249Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5649ISCH CONTAINMT/NARROW M-L SO1128.2122222201NANA 5250Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5650TOT CONTACT AK/KNEE DISART S1128.1827777801NANA 5251Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5631AK/KNEE DISARTIC ACRYLIC SOC1128.2766666701NANA 5252Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5999LOWR EXTREMITY PROSTHES NOS1128.0880555601NANA 5253Carrier M2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5828ENDO KNEE-SHIN FLUID SWG/STA1128.257501NANA 5254Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5845KNEE-SHIN SYS STANCE FLEXION1128.2630555601NANA 5255Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5652SUCTION SUSP AK/KNEE DISART1128.2511111101NANA 5256Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.1977777801NANA 5257Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5968MULTIAXIAL ANKLE W DORSIFLEX1121.8994444401NANA 5258Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8460SHRINKER ABOVE KNEE1128.2388888901NANA 5259Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5649ISCH CONTAINMT/NARROW M-L SO1128.2122222201NANA 5260Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5650TOT CONTACT AK/KNEE DISART S1128.1827777801NANA 5261Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5651AK FLEX INNER SOCKET EXT FRA1128.2047222201NANA 5262Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5999LOWR EXTREMITY PROSTHES NOS1128.0880555601NANA 5263Carrier M2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5631AK/KNEE DISARTIC ACRYLIC SOC1128.2766666701NANA 5264Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0486ORAL DEVICE/APPLIANCE CUSFAB2159.6704166702NANA 5265Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5845KNEE-SHIN SYS STANCE FLEXION1128.2630555601NANA 5266Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5920ENDO AK/HIP ALIGNABLE SYSTEM1128.1977777801NANA 5267Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5968MULTIAXIAL ANKLE W DORSIFLEX1121.8994444401NANA 5268Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5652SUCTION SUSP AK/KNEE DISART1128.2511111101NANA 5269Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5649ISCH CONTAINMT/NARROW M-L SO1128.2122222201NANA 5270Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5650TOT CONTACT AK/KNEE DISART S1128.1827777801NANA 5271Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5631AK/KNEE DISARTIC ACRYLIC SOC1128.2766666701NANA 5272Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5999LOWR EXTREMITY PROSTHES NOS1128.0880555601NANA 5273Carrier M2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5828ENDO KNEE-SHIN FLUID SWG/STA1128.257501NANA 5274Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7970.5226.47758901214.7008832501796180SEMAGLUTIDERYBELSUS,OZEMPIC 5275Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3510.72651.4725440387.2798934690802710TESTOSTERONEANDROGEL 5276Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3030.82186.56642205610.367177080672360SEMAGLUTIDEWEGOVY 5277Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2940.391213.8661646613.648846430742200TIRZEPATIDEMOUNJARO 5278Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2380.89921.4800177311.48573750471910OMEPRAZOLEOMEPRAZOLE 5279Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2270.581514.3548755819.519862990901370AMPHET/DEXTRADDERALL,MYDAYIS 5280Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1890.73542.53364734312.014646610231660TACROLIMUSPROTOPIC 5281Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1780.67428.01510802536.257706510341440DUPILUMABDUPIXENT 5282Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1560.76285.2420643949.8552967710431130DULAGLUTIDETRULICITY 5283Carrier M2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1430.88810.7642695479.4549050930271160PANTOPRAZOLEPANTOPRAZOLE 5284Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3610.16.7504320CLASCOTERONEWINLEVI 5285Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1710.114.6666666701160LANSOPRAZOLELANSOPRAZOLE 5286Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1410.11802120RABEPRAZOLERABEPRAZOLE,PANTOPRAZOLE,OMEPRAZOLE 5287Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1313615.2727272702110IMMUNE GLOBULINHIZENTRA 5288Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1210.10.101110PLECANATIDETRULANCE 5289Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA11114.4120560DIROXIMEL FUMARATEVUMERITY 5290Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1110.114.401100TAZAROTENE TOPICALARAZLO 5291Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010.13780640MORPHINE SULMORPHINE 5292Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA916280450BUPROPION/DEXTROMETHORPHANAUVELITY 5293Carrier M2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81360800VALGANCICLOVIRVALGANCICLOVIR 5294Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA91480.10270SEMIGLUTIDEWEGOVY 5295Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA41240.10130SEMIGLUTIDERYBELSUS,OZEMPIC 5296Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA41120160130LIRAGLUTIDESAXENDA 5297Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA410.1400130USTEKINUMABSTELARA 5298Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.1240120TESTOSTERONETESTOSTERONE,DEPO-TESTOSTERONE 5299Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.1360120METHYLPHENIDATECONCERTA,JORNAY,QUILLIVANT,RELEXXII 5300Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA310.10.10210MODAFINILMODAFINIL 5301Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3116030FREMANEZUMAB-VFRMAJOVY 5302Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3132030DUPILUMABDUPIXENT 5303Carrier M2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2124020TIRZEPATIDEMOUNJARO,TIRZEPATIDE 5304Carrier 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)80.62514.4940.71171NANA 5305Carrier 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)60.833314.4930.415NANA 5306Carrier 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)50.837.1351NANA 5307Carrier 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; lumbar50.849.3251NANA 5308Carrier 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; lumbar40.7514.4937.6813NANA 5309Carrier 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 graft400.012.1613NANA 5310Carrier 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); lumbar40.7540.8841NANA 5311Carrier 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)30.666757.7997232NANA 5312Carrier 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)3181.6597232NANA 5313Carrier 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)20.559.8721NANA 5314Carrier A2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT47563Laparoscopy, surgical; cholecystectomy with cholangiography201.262NANA 5315Carrier 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 ileocolostomy205.020.0111NANA 5316Carrier 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)200.092NANA 5317Carrier 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)20.558.672NANA 5318Carrier 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)200.092NANA 5319Carrier 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)20.556.332NANA 5320Carrier 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)201.240.0911NANA 5321Carrier 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)3181.6597232NANA 5322Carrier 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)11107.8976811NANA 5323Carrier 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 allograft1120.751NANA 5324Carrier 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 interpretation111.631NANA 5325Carrier 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 approach1163.61NANA 5326Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion11107.891NANA 5327Carrier 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; lumbar112.5476811NANA 5328Carrier 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)116.941NANA 5329Carrier A2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64999Unlisted procedure, nervous system116.941NANA 5330Carrier 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 segment1153.631NANA 5331Carrier 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, reducible1191.061NANA 5332Carrier 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 flexibility4250.6820.69425NANA 5333Carrier 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 minutes3800.678921.57380NANA 5334Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple3590.96664.6614.27103491NANA 5335Carrier 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)3360.95544.6619.3240103261NANA 5336Carrier 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 minutes3270.648322.03327NANA 5337Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete3080.91235.65308NANA 5338Carrier 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 activities2560.652319.94256NANA 5339Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr2310.88316.61231NANA 5340Carrier 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 technique2200.97737.4914.8927662142NANA 5341Carrier A2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT abd & pelv w contrast1670.95210.284.831166NANA 5342Carrier 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)33134.3633NANA 5343Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng2610.69120261NANA 5344Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70552Contrast MRI of brain201020NANA 5345Carrier 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 forceps19111.2319NANA 5346Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl1810.0118NANA 5347Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72157MRI of thoracic spine1611.4716NANA 5348Carrier 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 si16142.16161NANA 5349Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45381Colonoscopy, flexible; with directed submucosal injection(s), any substance1410.0218.05113NANA 5350Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78816Imaging PET/CT full body1317.6913NANA 5351Carrier A2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70543MRI orb/fc/nck w/o cntrst flwd cntr1118.9511NANA 5352Carrier 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)60.16670.6614.7315NANA 5353Carrier A2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148MRI of lumbar spine1630.012316.27163NANA 5354Carrier 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 CNTRST950.01050.278.181681941NANA 5355Carrier 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 contr2310.00436.61231NANA 5356Carrier A2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder7136.667NANA 5357Carrier A2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder7136.667NANA 5358Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-360.88893.3836NANA 5359Carrier 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; individual200.4542.2620NANA 5360Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services20117.3620NANA 5361Carrier 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 management80.7534.72136.7326NANA 5362Carrier 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 session80.7534.72136.7326NANA 5363Carrier 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 management80.7534.72136.7326NANA 5364Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem60.833354.386NANA 5365Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours5138.045NANA 5366Carrier 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)2119.392NANA 5367Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551MRI of brain210.072NANA 5368Carrier A2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834Psychotherapy, 45 minutes with patient204.152NANA 5369Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services20117.3620NANA 5370Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours5138.045NANA 5371Carrier 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)2119.392NANA 5372Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain210.072NANA 5373Carrier 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)11114.661NANA 5374Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1101NANA 5375Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21209Osteoplasty, facial bones; reduction11114.661NANA 5376Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21137Reduction forehead; contouring only11114.661NANA 5377Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21270Malar augmentation, prosthetic material11114.661NANA 5378Carrier 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 flexibility1119.141NANA 5379Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete1122.641NANA 5380Carrier 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 minutes1119.141NANA 5381Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2035Alcohol and/or other drug treatment program, per hour1172.131NANA 5382Carrier 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 tip11114.661NANA 5383Carrier A2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction1122.641NANA 5384Carrier 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]3000.952.13300NANA 5385Carrier 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)140.92864.0514NANA 5386Carrier 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)70.85716.577NANA 5387Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal20.512.992NANA 5388Carrier A2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable1146.441NANA 5389Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable1146.441NANA 5390Carrier 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]3000.952.13300NANA 5391Carrier 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)140.92864.0514NANA 5392Carrier 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)70.85716.577NANA 5393Carrier A2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal20.512.992NANA 5394Carrier 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]3000.00332.13300NANA 5395Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin50.612.015NANA 5396Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml404.540.0131NANA 5397Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc1020.261NANA 5398Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4217Sterile water/saline, 500 ml100.011NANA 5399Carrier A2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl1020.261NANA 5400Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin50.612.015NANA 5401Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml404.540.0131NANA 5402Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc1020.261NANA 5403Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4217Sterile water/saline, 500 ml100.011NANA 5404Carrier A2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl1020.261NANA 5405Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA520.634628.1946.092725HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN 5406Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA520.30777.432844SEMAGLUTIDEOZEMPIC, RYBELSUS 5407Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA500.8234.5852.451139ADALIMUMABHUMIRA 5408Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA460.195718.6941.79442TIRZEPATIDEMOUNJARO 5409Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA320.8751.6828.39131CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, RESTASIS 5410Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.833310.6779.91618DUPILUMABDUPIXENT, DUPIXENT DUPILUMAB 5411Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2406.310.21321SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 5412Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA220.63646.7342.8913OXYCODONE HCLOXYCODONE HCL, OXYCONTIN 5413Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA160.756.09192.26511GALCANEZUMAB-GNLMEMGALITY 5414Carrier A2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA160.81252.4940.85214ETANERCEPTENBREL 5415Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12118.0162.8348FREMANEZUMAB-VFRMAJOVY 5416Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1218.3127.1439PLECANATIDETRULANCE 5417Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9137.5741.5918RISANKIZUMAB-RZAASKYRIZI 5418Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA715.181.761OXYCODONE W/ ACETAMINOPHENOXYCODONE-ACETAMINOPHEN 5419Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6133.9306TOCILIZUMABACTEMRA 5420Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5113.0424.6641BUPRENORPHINEBUPRENORPHINE 5421Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511.436.5214DULAGLUTIDETRULICITY 5422Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4114.7340.7413UPADACITINIBRINVOQ/ER 5423Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4110.140BUPRENORPHINE HCLBELBUCA 5424Carrier A2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA311.9837.8312LIFITEGRASTXIIDRA 5425Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA217.7320HYDROCODONE BITARTRATEHYDROCODONE BITARTRATE 5426Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11309.7601SIPONIMOD FUMARATEMAYZENT 5427Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11265.8601NICOTINENICOTROL 5428Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11234.6201ERENUMAB-AOOEAIMOVIG 5429Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.425.0597.1811EVOLOCUMABREPATHA SURECLICK 5430Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.3333267.93101.6721ADALIMUMABHUMIRA 5431Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.333376.7701ETANERCEPTENBREL 5432Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.252.7710DUPILUMABDUPIXENT DUPILUMAB 5433Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.125306.2610OXYCODONE HCLOXYCODONE HCL 5434Carrier A2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.07695.8910FLUTICASONE PROPIONATE HFAFLOVENT HFA 5435Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44205LAP COLECTOMY PART W/ILEUM21000020NANA 5436Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTOMY21000020NANA 5437Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y110240010NANA 5438Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27299UNLISTED PX PELVIS/HIP JOINT110240010NANA 5439Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT51590REMOVE BLADDER/REVISE TRACT11000010NANA 5440Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT62165REMOVE PITUIT TUMOR W/SCOPE11000010NANA 5441Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93654COMPRE EP EVAL TX VT110240010NANA 5442Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY11000010NANA 5443Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19361BRST RCNSTJ LATSMS DRSI FLAP110240010NANA 5444Carrier N2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMO PROLONG INFUSE W/PUMP110480010NANA 5445Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44205LAP COLECTOMY PART W/ILEUM21000020NANA 5446Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207L COLECTOMY/COLOPROCTOSTOMY21000020NANA 5447Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y110240010NANA 5448Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27299UNLISTED PX PELVIS/HIP JOINT110240010NANA 5449Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT51590REMOVE BLADDER/REVISE TRACT11000010NANA 5450Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT62165REMOVE PITUIT TUMOR W/SCOPE11000010NANA 5451Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93654COMPRE EP EVAL TX VT110240010NANA 5452Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPARO PARTIAL COLECTOMY11000010NANA 5453Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19361BRST RCNSTJ LATSMS DRSI FLAP110240010NANA 5454Carrier N2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMO PROLONG INFUSE W/PUMP110480010NANA 5455Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY390.974012.900390NANA 5456Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA300.767342108.904260NANA 5457Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM210.9052485.201200NANA 5458Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE170.82424011401160NANA 5459Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ7323EUFLEXXA INJ PER DOSE150.8672454.901140NANA 5460Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA140.92910210320860NANA 5461Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN130.769079.400130NANA 5462Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479UNLISTED MOLECULAR PATHOLOGY120.83304600120NANA 5463Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION810330080NANA 5464Carrier N2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION70.8570240070NANA 5465Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92507SPEECH/HEARING THERAPY380.974010.100380NANA 5466Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA230.767552117.801220NANA 5467Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM190.9052462.701180NANA 5468Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE140.8240113.100140NANA 5469Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ7323EUFLEXXA INJ PER DOSE130.867243801120NANA 5470Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA130.929113.110320760NANA 5471Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81479UNLISTED MOLECULAR PATHOLOGY100.83303600100NANA 5472Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN100.769074.400100NANA 5473Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035BEVACIZUMAB INJECTION810330080NANA 5474Carrier N2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9276DISPOSABLE SENSOR, CGM SYS7148440160NANA 5475Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22633Arthrodesis214800200NANA 5476Carrier 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 pregnancy212400200NANA 5477Carrier 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 Nose112400100NANA 5478Carrier 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�1104320010NANA 5479Carrier 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 DEVICE1108400010NANA 5480Carrier 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.1101440010NANA 5481Carrier 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 material1109840010NANA 5482Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL2055Hip-knee-ankle-foot Orthotics11024480010NANA 5483Carrier 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.11030960010NANA 5484Carrier N2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTQ5103INFLECTRA1102640010NANA 5485Carrier N2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124MENTAL HEALTH INPATIENT3100300NANA 5486Carrier N2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002SUBSTANCE ABUSE RESIDENTIAL2100200NANA 5487Carrier N2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001MENTAL HEALTH RESIDENTIAL1000100NANA 5488Carrier N2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124MENTAL HEALTH INPATIENT3100300NANA 5489Carrier N2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002SUBSTANCE ABUSE RESIDENTIAL2100200NANA 5490Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION (TMS)4100040NANA 5491Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM2100020NANA 5492Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION2100020NANA 5493Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853MENTAL HEALTH GROUP THERAPY1100010NANA 5494Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035EATING DISORDER PARTIAL HOSPITALIZATION PROGRAM1100010NANA 5495Carrier N2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT036TAPPLIED BEHAVIORAL ANALYSIS1100010NANA 5496Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION (TMS)4100040NANA 5497Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM2100020NANA 5498Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION2100020NANA 5499Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853MENTAL HEALTH GROUP THERAPY1100010NANA 5500Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035EATING DISORDER PARTIAL HOSPITALIZATION PROGRAM1100010NANA 5501Carrier N2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT036TAPPLIED BEHAVIORAL ANALYSIS1100010NANA 5502Carrier N2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97151ABA Therapy1102640010NANA 5503Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5645BK FLEX INNER SOCKET EXT FRA1101440010NANA 5504Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5301BK MOLD SOCKET SACH FT ENDO1101440010NANA 5505Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5679SOCKET INSERT W/O LOCK MECH1101440010NANA 5506Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5629BELOW KNEE ACRYLIC SOCKET1101440010NANA 5507Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8699PROSTHETIC IMPLANT NOS10000010NANA 5508Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5637BELOW KNEE TOTAL CONTACT1101440010NANA 5509Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5940ENDO BK ULTRA-LIGHT MATERIAL1101440010NANA 5510Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH110960010NANA 5511Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5685BELOW KNEE SUS/SEAL SLEEVE1101440010NANA 5512Carrier N2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL5620TEST SOCKET BELOW KNEE1101440010NANA 5513Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5645BK FLEX INNER SOCKET EXT FRA1101440010NANA 5514Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5301BK MOLD SOCKET SACH FT ENDO1101440010NANA 5515Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5679SOCKET INSERT W/O LOCK MECH1101440010NANA 5516Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5629BELOW KNEE ACRYLIC SOCKET1101440010NANA 5517Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5637BELOW KNEE TOTAL CONTACT1101440010NANA 5518Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5940ENDO BK ULTRA-LIGHT MATERIAL1101440010NANA 5519Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH110960010NANA 5520Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5685BELOW KNEE SUS/SEAL SLEEVE1101440010NANA 5521Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL5620TEST SOCKET BELOW KNEE1101440010NANA 5522Carrier N2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0861PWC GP3 STD MULT POW OPT S/B110960010NANA 5523Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA790.371.3828.5309700SemaglutideOZEMPIC 5524Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA630.84131.0338.58016470RimegepantNURTEC 5525Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA450.82.3440.82508370SsemaglutideWEGOVY 5526Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA430.470.26252.87507360SsemaglutideOZEMPIC 5527Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA380.928.0729.725010280SsemaglutideOZEMPIC 5528Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.5610.98552.64015210LisdexamfetamineVYVANSE 5529Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.891.3420.695015210DeucravacitinibSTELARA 5530Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA340.560.9633.9206280RuxolitinibOPZELURA 5531Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA330.391.4419.2502310TirzepatideMOUNJARO 5532Carrier N2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA310.2957.62560.77016150EmtricitabineTenofovir Alafenamide)DESCOVY 5533Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA271116.6406210AdalimumabHUMIRA 5534Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2410.0123.501680ApixabanELIQUIS 5535Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1610.010.0202140DupilumabDUPIXENT 5536Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1511.0513.720690Amphetamine and DextroamphetamineDEXTROAMPHETAMINE 5537Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA13111.5117.0702110EvolocumabREPATHA SURECLICK 5538Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1310.0134.530490Risankizumab-rzaaSKYRIZI PEN 5539Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010.010.010550ConcertaMETHYLPHENIDATE ER 5540Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1016.700100SsemaglutideWEGOVY 5541Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA918.860.040720MenotropinsMENOPUR 5542Carrier N2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA911.62470360Erenumab-aooeAIMOVIG 5543Carrier N2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA313200300UstekinumabSTELARA 5544Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853METALLIC MESH BETWEEN VERTEBRAE130.92310189.8800130NANA 5545Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930BONE GRAFT MATERIAL ATTACHED TO SPINE100.7054.0200100NANA 5546Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK101061.2200100NANA 5547Carrier 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 DEFORMITY91040.120090NANA 5548Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614SPINAL FUSION TO JOIN TWO VERTEBRAE91049.390090NANA 5549Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048ADDITIONAL VERTEBRAE SEGMENT DURING ANOTHER PROCEDURE90.8889056.060090NANA 5550Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION910245.010090NANA 5551Carrier 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 DEFORMITY90.44440244.270090NANA 5552Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63047INCISION AT A SINGLE VERTEBREA TO CORRECT SPINAL STENOSIS80.8750270.730080NANA 5553Carrier B2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT TO BONE DURING SPINAL SURGERY71055.360070NANA 5554Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22848SPINAL DEVICE FIXATION TO PELVIC BONES11011.930010NANA 5555Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63046SINGLE THORACIC VERTEBRAL TO CORRECT STENOSIS21094.060020NANA 5556Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487REVISION OF KNEE JOINT WITH FEMORAL AND TIBIAL COMPONENTS11077.870010NANA 5557Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE11164.8300100NANA 5558Carrier 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-C2.710317.790070NANA 5559Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20939AUTOGRAFT TO BONE DURING SPINAL SURGERY21022.280020NANA 5560Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734MUSCLE FLAP FROM AN AREA OF THE TRUNK110.8900100NANA 5561Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20939BONE MARROW HARVEST TO USE AS A BONE GRAFT21022.280020NANA 5562Carrier B2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63045SINGLE CERVICAL VERTEBRAL PROCEDURE21033.390020NANA 5563Carrier 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 PAIN11050.880010NANA 5564Carrier B2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT44204LAPAROSCOPIC PARTIAL REMOVAL OF COLON1100.120010NANA 5565Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD1410.7305083.31001410NANA 5566Carrier 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 MACHINE1110.7027072.27001110NANA 5567Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN970.532147.77131.120.0710861NANA 5568Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-14580.5347078.5800580NANA 5569Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-7560.5053077.2300560NANA 5570Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0483DEFINITIVE DRUG TEST OF CLASSES 22+560.0215078.5100560NANA 5571Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ0585INJECTION,ONABOTULINUMTOXINA930.817211.634.1707860NANA 5572Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0482DEFINITIVE DRUG TEST OF CLASSES 15-22550.022078.9200550NANA 5573Carrier 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 SETTING6510116.500650NANA 5574Carrier B2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ3489ZOLEDRONIC ACID 1MG (ZOMETA)830.915728.6719.4703800NANA 5575Carrier 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 SPINE01000000NANA 5576Carrier 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)114.1900100NANA 5577Carrier 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 TARGETING1124.5800100NANA 5578Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9145INJECTION DARATUMUMAB 10 MG (DARZALEX)-CHEMOTHERAPY11044.580010NANA 5579Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31575LARYNGOSCOPY FLEXIBLE FIBEROPTIC TO LOOK INSIDE THE LARYNX01000000NANA 5580Carrier 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 GENES310209.250030NANA 5581Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9304INJECTION PEMETREXED PEMFEXY 10 MG FOR CHEMOTHERAPY1100.030010NANA 5582Carrier 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 TECHNIQUES210228.850020NANA 5583Carrier B2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue650ROUTINE HOME HOSPICE CARE DELIVERED IN A NURSING FACILITY01000000NANA 5584Carrier 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 GROUP210228.850020NANA 5585Carrier 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 FOOT01000000NANA 5586Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95024ALLERGY SKIN TESTING01000000NANA 5587Carrier 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.01000000NANA 5588Carrier 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-PHYSICIAN01000000NANA 5589Carrier 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 BEFORE11075.470010NANA 5590Carrier 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 MINUTES01000000NANA 5591Carrier 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 PINS01000000NANA 5592Carrier B2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90677PNEUMONIA VACCINE FOR INTRAMUSCULAR USE01000000NANA 5593Carrier 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 ANESTHESIA01000000NANA 5594Carrier 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 PANEL01000000NANA 5595Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY1130.9187022.18001130NANA 5596Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY670.9851014.1700670NANA 5597Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED34107.8300340NANA 5598Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue100ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY31011.210030NANA 5599Carrier B2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC11030.670010NANA 5600Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED34107.8300340NANA 5601Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC11030.670010NANA 5602Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue100ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY31011.210030NANA 5603Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY670.9851014.1700670NANA 5604Carrier B2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY1130.9187022.18001130NANA 5605Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM481045.7200480NANA 5606Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES291040.6500290NANA 5607Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY131038.2800130NANA 5608Carrier 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 PATIENT101048.9600100NANA 5609Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS910106.910090NANA 5610Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHOLOGICAL DIAGNOSTIC EVALUATION110189.80010NANA 5611Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM21000020NANA 5612Carrier 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.21061.370020NANA 5613Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES2100.120020NANA 5614Carrier B2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR21023.190020NANA 5615Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS910106.910090NANA 5616Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156ADAPTIVE BEHAVIOR TREATMENT PROCEDURES2100.120020NANA 5617Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC EVALUATION IN ADDITION TO RENDERING ADDITIONAL MEDICAL SERVICES01000000NANA 5618Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY131038.2800130NANA 5619Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213OFFICE/OUTPATIENT VISIT TO AN ESTABLISHED PATIENT11000010NANA 5620Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHOLOGICAL DIAGNOSTIC EVALUATION110189.80010NANA 5621Carrier 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.21061.370020NANA 5622Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION USED TO IMPROVE DEPRESSION11023.620010NANA 5623Carrier 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 MINUTES2100.120020NANA 5624Carrier B2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90869TRANSCRANIAL MAGNETIC STIMULATION SUBSQUENT REDETERMINATION11024.620010NANA 5625Carrier B2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY130.0714038.2800130NANA 5626Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE5490.92754.6175.54055440NANA 5627Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR1000.830428.0281.7708920NANA 5628Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH590.915339.9276.8201580NANA 5629Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS410.891312.156.8802390NANA 5630Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP320.878817.8570.7601310NANA 5631Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE160.523.6597.5202140NANA 5632Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP101070.300100NANA 5633Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399DURABLE MEDICAL EQUIPMENT NOT CLASSIFIED ELSEWHERE110.818232.1171.4501100NANA 5634Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP91061.050090NANA 5635Carrier B2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENTILATOR, USED WITH NON-INVASIVE INTERFACE (MASK, CHEST SHELL)80.750116.740080NANA 5636Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2313POWER WHEELCHAIR HARNESS11044.760010NANA 5637Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8690AUDITORY OSSEOINTEGRATED DEVICE INCLUDES ALL INTERNAL & EXTERNAL COMPONENTS31073.940030NANA 5638Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005ULTRALIGHTWEIGHT WHEELCHAIR210113.670020NANA 5639Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM11000010NANA 5640Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0188SYNTHETIC SHEEPSKIN PAD110140.540010NANA 5641Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0261HOSPITAL BED SEMI-ELECTRIC WITH ANY RAILS AND WITHOUT MATTRESS210193.260020NANA 5642Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP101070.300100NANA 5643Carrier B2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0277POWERED PRESS-REDUCING AIR MATRESS1132.1100100NANA 5644Carrier 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 WEIGHT11044.760010NANA 5645Carrier 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 MATTRESS417.7567.660130NANA 5646Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1161MANUAL ADLUT SIZE WHEELCHAIR INCLUIDING TILT SPACE20.5070.060020NANA 5647Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0108OTHER ACCESSORY NOT LISTED40.25081.180040NANA 5648Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0001STANDARD WHEELCHAIR50.2057.770050NANA 5649Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0630PATIENT LIFT HYDRAULIC50.250.3970.570140NANA 5650Carrier 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 DEVICE70.125082.960070NANA 5651Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0935PASSIVE MOTION EXERCISE DEVICE160.12523.6597.5202140NANA 5652Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399DURABLE MEDICAL EQUIPMENT NOT CLASSIFIED ELSEWHERE110.090932.1171.4501100NANA 5653Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1390PORTABLE OXYGEN CONCENTRATOR1000.044628.0281.7708920NANA 5654Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE5490.019654.6175.54055440NANA 5655Carrier B2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4239CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH590.016939.9276.8201580NANA 5656Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY390.97513.7971.4902370NANA 5657Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN141063.3800140NANA 5658Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING71064.280070NANA 5659Carrier B2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM210100.740020NANA 5660Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN141063.3800140NANA 5661Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING71064.280070NANA 5662Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9274EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM210100.740020NANA 5663Carrier B2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY390.97513.7971.4902370NANA 5664Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA11600.627613606221939SemaglutideOzempic 5665Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5310.3071994369462Clobetasol PropionateClobetasol 5666Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3580.6872941787271LiraglutideVictoza 5667Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3550.89011128170285DulaglutideTrulicity 5668Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3450.31342963100245PregabalinPregabalin 5669Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2550.917639653113142Hydrocodone-AcetaminophenHydroco/apap 5670Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2330.81551723370163Lisdexamfetamine DimesylateVyvanse 5671Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2020.792127107436166AdalimumabHumira Pen 5672Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1830.8907755379786Oxycodone HClOxycodone 5673Carrier B2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1820.554919114324158Continuous Glucose System SensorFreesty Libr 5674Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1615515579Sodium Zirconium CyclosilicateLokelma 5675Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA111283011Oxybutynin ChlorideOxybutynin 5676Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1114275638Segesterone Acetate-Ethinyl EstradiolAnnovera 5677Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA101783010Fluticasone Propionate HFAFlovent Hfa 5678Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA914935654Insulin AspartNovolog 5679Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA811026EtonogestrelNexplanon 5680Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8177071DasatinibSprycel 5681Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA811035Levonorgestrel (IUD)Mirena 5682Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7174907Ketoconazole (Topical)Ketoconazole 5683Carrier B2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7117876952Trifluridine-TipiracilLonsurf 5684Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL12121.217.8210NANA 5685Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES1011.0617.319NANA 5686Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN5111.65NANA 5687Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES5110.65NANA 5688Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS3114.63NANA 5689Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT3118.23NANA 5690Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue762SPECIALTY SERVICES, OBSERVATION HOURS3120.63NANA 5691Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue158ROOM & BOARD, WARD - REHABILITATION3116.73NANA 5692Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99232SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES2102NANA 5693Carrier E2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71045RADIOLOGIC EXAM CHEST SINGLE VIEW218.12NANA 5694Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL12121.217.8210NANA 5695Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES1011.0617.319NANA 5696Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN5111.65NANA 5697Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES5110.65NANA 5698Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS3114.63NANA 5699Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT3118.23NANA 5700Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762SPECIALTY SERVICES, OBSERVATION HOURS3120.63NANA 5701Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue158ROOM & BOARD, WARD - REHABILITATION3116.73NANA 5702Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99232SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES2102NANA 5703Carrier E2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71045RADIOLOGIC EXAM CHEST SINGLE VIEW218.12NANA 5704Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES3000.99337.860.720280NANA 5705Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS1870.96790.877.45182NANA 5706Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES1400.99299.452.25135NANA 5707Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN1180.898317.4219.64114NANA 5708Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST11811742.84078NANA 5709Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST8217.217.91666NANA 5710Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45378COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD770.987106.677NANA 5711Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST7211330.63537NANA 5712Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST6917.522.23633NANA 5713Carrier E2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141MRI CERVICAL SPINE NO CONTRAST66114.416.41452NANA 5714Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST11811742.84078NANA 5715Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST8217.217.91666NANA 5716Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST7211330.63537NANA 5717Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST6917.522.23633NANA 5718Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI CERVICAL SPINE NO CONTRAST66114.416.41452NANA 5719Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS6311.429.2558NANA 5720Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73221MRI RIGHT SHOULDER NO CONTRAST5518.420.62926NANA 5721Carrier 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 TQ52119.852NANA 5722Carrier 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 5723Carrier E2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN NO CONTRAST43112.324.41627NANA 5724Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA56589BARIUM SWALLOW STUDIES, MODIFIED111466.51NANA 5725Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64615CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE113151NANA 5726Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ3490UNCLASSIFIED DRUGS20.515.32NANA 5727Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99201OFFICE OUTPATIENT NEW 10 MINUTES20.5505.22NANA 5728Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT25043REFERRAL PHYSICAL THERAPY CANCER REHAB50.2303.65NANA 5729Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43239EGD TRANSORAL BIOPSY SINGLE/MULTIPLE100.152.664.219NANA 5730Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23660EXT REFERRAL PEDS130.0820.2231.349NANA 5731Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20041REFERRAL THERAPY, SPEECH AND LANGUAGE290.071259.4524NANA 5732Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99205OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES310.0625.7405.8427NANA 5733Carrier E2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97110THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES250.04324.625NANA 5734Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC53117.121.6449NANA 5735Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION26137.635.5179NANA 5736Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP21143.988.4192NANA 5737Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC13136.681121NANA 5738Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV51725NANA 5739Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES1174.51NANA 5740Carrier E2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue200INTENSIVE CARE, GENERAL112.61NANA 5741Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC53117.121.6449NANA 5742Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION26137.635.5179NANA 5743Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP21143.988.4192NANA 5744Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC13136.681121NANA 5745Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV51725NANA 5746Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES1174.51NANA 5747Carrier E2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue200INTENSIVE CARE, GENERAL112.61NANA 5748Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION690.9565106.269NANA 5749Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN52153.652NANA 5750Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES37169.237NANA 5751Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99205OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES25175.725NANA 5752Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN23127.823NANA 5753Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS19150.8430.2181NANA 5754Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR18142.918NANA 5755Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN17156.517NANA 5756Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN16159.316NANA 5757Carrier E2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIA13134.5109.1121NANA 5758Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN52153.652NANA 5759Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES37169.237NANA 5760Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99205OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES25175.725NANA 5761Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN23127.823NANA 5762Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS19150.8430.2181NANA 5763Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR18142.918NANA 5764Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN17156.517NANA 5765Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN16159.316NANA 5766Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIA13134.5109.1121NANA 5767Carrier E2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90899UNLISTED PSYCHIATRIC SERVICE/PROCEDURE1110.633.7110NANA 5768Carrier E2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION690.01270.9107.7168NANA 5769Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S16114.77.65156NANA 5770Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS118123.4118NANA 5771Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1160.99148.663.32195NANA 5772Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR89111.22.9584NANA 5773Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION79120.379NANA 5774Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE60124.460NANA 5775Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR5517.611.2253NANA 5776Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF5310.724.3152NANA 5777Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM29111.215.3722NANA 5778Carrier E2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB4161ENTERAL F PED HYDROLYZED/AA&PEPTIDE CHAIN PROTS2915.629NANA 5779Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S16114.77.65156NANA 5780Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS118123.4118NANA 5781Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR89111.22.9584NANA 5782Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION79120.379NANA 5783Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE60124.460NANA 5784Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR5517.611.2253NANA 5785Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF5310.724.3152NANA 5786Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM29111.215.3722NANA 5787Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4161ENTERAL F PED HYDROLYZED/AA&PEPTIDE CHAIN PROTS2915.629NANA 5788Carrier E2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0691UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS28121.528NANA 5789Carrier E2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP1160.018.663.32195NANA 5790Carrier E2023Diabetes 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 subcutaneou970.381438.297NANA 5791Carrier E2023Diabetes 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 SERVICE18118.118NANA 5792Carrier E2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL11133.611NANA 5793Carrier E2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN9138.89NANA 5794Carrier E2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC5111.15NANA 5795Carrier E2023Diabetes 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 DRESS1144.31NANA 5796Carrier E2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH11691NANA 5797Carrier E2023Diabetes 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 SERVICE18118.118NANA 5798Carrier E2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL11133.611NANA 5799Carrier E2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN9138.89NANA 5800Carrier E2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC5111.15NANA 5801Carrier E2023Diabetes 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 DRESS1144.31NANA 5802Carrier E2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH11691NANA 5803Carrier E2023Diabetes 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 subcutaneou970.381438.297NANA 5804Carrier E2023Diabetes 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 subcutaneou970.0338.297NANA 5805Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1970.807179.3211731501970EMPAGLIFLOZINJARDIANCE 5806Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA870.321867.430689660870SEMAGLUTIDEOZEMPIC, RYBELSUS 5807Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA690.91324.148526570690UBROGEPANTUBRELVY 5808Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA660.712133.742630470660LISDEXAMFETAMINE DIMESYLATEVYVANSE 5809Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA520.461540.64250520VARENICLINE TARTRATEAPO-VARENICLINE 5810Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA460.978331.749082130460RIVAROXABANXARELTO 5811Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA46127.571714980460FREMANEZUMAB-VFRMAJOVY 5812Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.472231.196550930360LIRAGLUTIDEVICTOZA 5813Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA33122.992373740330SECUKINUMABCOSENTYX 5814Carrier E2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA320.781346.115694440320TESTOSTERONE CYPIONATEDEPO-TESTOST 5815Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA46127.60460FREMANEZUMAB-VFRMAJOVY 5816Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA331230330SECUKINUMABCOSENTYX 5817Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA22113.60220TESTOSTERONEANDRODERM, TESTOSTERONE 5818Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA22177.30220TICAGRELORBRILINTA 5819Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA201590200SACUBITRIL-VALSARTANENTRESTO 5820Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12123.50120TOFACITINIB CITRATEXELJANZ 5821Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12123.80120CARIPRAZINE HCLVRAYLAR 5822Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12127.10120GUSELKUMABTREMFYA 5823Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8133.6080ERENUMAB-AOOEAIMOVIG 5824Carrier E2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7121.6070APREMILASTOTEZLA 5825Carrier E2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.568.78020ZOLMITRIPTANZOMIG 5826Carrier E2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA70.285733.75070RIFAXIMINXIFAXAN 5827Carrier E2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA520.038540.640520VARENICLINE TARTRATEAPO-VARENICLINE 5828Carrier E2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA360.027831.20360LIRAGLUTIDEVICTOZA 5829Carrier E2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1970.015279.3201970EMPAGLIFLOZINJARDIANCE 5830Carrier E2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA690.014524.150690UBROGEPANTUBRELVY 5831Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV451137.51440NANA 5832Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV29122.533.42270NANA 5833Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST1611114.51150NANA 5834Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU120.7593.50120NANA 5835Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y12175.20120NANA 5836Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99404PREV MED COUNSELING IND 53-67 MIN8161080NANA 5837Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32650THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA711317.4250NANA 5838Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY71139.3160NANA 5839Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST611332.8240NANA 5840Carrier C2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO6138.2060NANA 5841Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV451137.51440NANA 5842Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV29122.533.42270NANA 5843Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST1611114.51150NANA 5844Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y12175.20120NANA 5845Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99404PREV MED COUNSELING IND 53-67 MIN8161080NANA 5846Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32650THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA711317.4250NANA 5847Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOM HYSTERECTOMY71139.3160NANA 5848Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST611332.8240NANA 5849Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO6138.2060NANA 5850Carrier C2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50360TRANSPLANTATION OF KIDNEY6146.8060NANA 5851Carrier C2023Outpatient 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 MINS797010.97119.729.47679720220NANA 5852Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES111990.971114.626.8372108270NANA 5853Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE75640.990112.919.312674380NANA 5854Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT39940.99612.816.88139130NANA 5855Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER18960.989526.65724816480NANA 5856Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERA ACTVI DIRECT PAT CONTACT EA 15 MIN17360.980415.532.28216540NANA 5857Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96040GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY16350.997613.921.220314320NANA 5858Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN14350.968616.425.37813570NANA 5859Carrier C2023Outpatient 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 MINS14140.918719.538.720812060NANA 5860Carrier C2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,14130.827316.872.424211710NANA 5861Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000CYSTOURETHROSCOPY (SEP PROC)322112.224562660NANA 5862Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17000DESTRUCT 1ST AK PREMALIG LESION28111414.852760NANA 5863Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29881KNEE SCOPE,MED/LAT MENISECTOMY W/DEBRIDE/CHONDRO16911426.581610NANA 5864Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20550INJECT TENDON SHEATH / TRIGGER FINGER150112.533.341460NANA 5865Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ3301TRIAMCINOLONE ACETONIDE INJ PER 10 MG146114.526.461400NANA 5866Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT14000ADJ TIS TRANS/REARRANGE TRUNK DEFECT <10 SQCM143119.801430NANA 5867Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO CONGEN CARDIAC ANOMALIES133146.801330NANA 5868Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93270EVENT MONITOR - HOOKUP RECORD & DISCON ONLY124111.920.7231010NANA 5869Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76885ECHOGRAPHY OF INFANT HIPS, DYNAMIC112112.510.741080NANA 5870Carrier C2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93922NON-INVASIVE STUDY EXTREMITY ARTERY BILAT SINGLE1091831.631060NANA 5871Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93321ECHOCARDIOGRAPHY DOPPLER F/UP/LTD20.581020NANA 5872Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61885INSRT/REDO NEUROSTIM 1 ARRAY20.585.5020NANA 5873Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT85999UNLISTED HEMATOLOGY AND COAGULATION PRO30.33383.7030NANA 5874Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58559HYSTEROSCOPY W/ LYSIS INTRAUTERINE ADHES50.21248.7230NANA 5875Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19316MASTOPEXY50.23775140NANA 5876Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT60.167119112.2150NANA 5877Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78608BRAIN IMAGING PET METABOLIC70.14326.3138.3340NANA 5878Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22551ARTHRODESIS ANT INTERBODY CERVICAL BELOW C2160.12513110.51150NANA 5879Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81415EXOME ; SEQUENCE ANALYSIS100.12589.1280NANA 5880Carrier C2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77373STEREOTACTIC BODY RADIATION DELIVERY210.09519.33839120NANA 5881Carrier C2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128.102REF IP CD RESIDENTIAL TREATMENT CENTER3110.3300NANA 5882Carrier C2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY1170100NANA 5883Carrier C2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128.102REF IP CD RESIDENTIAL TREATMENT CENTER3110.3300NANA 5884Carrier C2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY1170100NANA 5885Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT100910.99442.92.932297690NANA 5886Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS34820.995132.913833440NANA 5887Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES6960.964118.522346620NANA 5888Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY5970.998317.35.335940NANA 5889Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR2530.96849.417.752480NANA 5890Carrier C2023Outpatient 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 MINS2420.880255152.432390NANA 5891Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT2280.80763.702280NANA 5892Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR1140.8684944.221120NANA 5893Carrier C2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES1140.921135.459.971070NANA 5894Carrier C2023Outpatient 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 MINS880.965975119.51870NANA 5895Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT191290190NANA 5896Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806.102REF MENTAL HEALTH EXTERNAL7125.6070NANA 5897Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90849MULT-FAMILY GROUP PSYCHOTHERAPY5141.8050NANA 5898Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96164HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PTS), FTF; INIT 30 MINS3113.3030NANA 5899Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAG STIMJ TX PLANNING213233110NANA 5900Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97152BEHAV IDENT-SUPPORT ASSESSMNT, ADM BY TECH/SUPV OF PHYS, EA 15 MINS1115010NANA 5901Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96167HEALTH BEHAVIOR INTERVENTION, FAMILY (WITH THE PATIENT PRESENT),FTF; INIT 30 MINS1115010NANA 5902Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96158HEALTH BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; INITIAL 30 MINS1111010NANA 5903Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64568INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER112010NANA 5904Carrier C2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806IND PSYCHOTHERAPY OFFICE 45-50 MIN1133010NANA 5905Carrier C2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90834PSYCHOTHERAPY 45 MIN PATIENT30.3331467120NANA 5906Carrier C2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT2280.00963.702280NANA 5907Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE30970.965513.53160324940NANA 5908Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE17210.997111.627.713014200NANA 5909Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA13230.99714.421.231110120NANA 5910Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE13170.992413.7013170NANA 5911Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL8870.98212.727.85713160NANA 5912Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT5760.9878624.42763000NANA 5913Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT5550.99825.518.625530NANA 5914Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR5520.996412.914205320NANA 5915Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1390OXYGEN CONCENTRATOR4010.97014.926.1933080NANA 5916Carrier C2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP38611216.143820NANA 5917Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP38611216.143820NANA 5918Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND35211503520NANA 5919Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN300115.132.5282720NANA 5920Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA28319.814.642790NANA 5921Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW21612115.632130NANA 5922Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR196113.816.2123730NANA 5923Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1833WARRIOR WRAP WITH HINGES/FLEX STOP1621160.711610NANA 5924Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4670AUTOMATIC BP MONITOR DIAL1491130.8251240NANA 5925Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8000BREAST PROSTHESIS MASTECTOMY BRA1491143231460NANA 5926Carrier C2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1830KO IMMOBILIZER CANVAS LONGIT141114.901410NANA 5927Carrier C2023DMECodes 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 & COMP20.598020NANA 5928Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5331HIP DISART CANADIAN SACH FT20.578.5020NANA 5929Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5920ADDN KNEE-SHIN ALIGNABLE20.566.5020NANA 5930Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5321AK OPEN END SACH20.5144.5020NANA 5931Carrier C2023DMECodes 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, EA60.16787.3060NANA 5932Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0005ULTRALIGHTWEIGHT WHEELCHAIR110.091123.90110NANA 5933Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4153ENTERAL FORMULAE CATEGORYIII130.077161081120NANA 5934Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE250.0430211240NANA 5935Carrier C2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER250.043081.44210NANA 5936Carrier C2023DMECodes 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 UNIT490.02105.40490NANA 5937Carrier C2023Diabetes 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 MINS14060.965114.824.97713290NANA 5938Carrier C2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER6920.725415.166.1686240NANA 5939Carrier C2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS5860.936913.934.73402460NANA 5940Carrier C2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN3900.989711.920.1233670NANA 5941Carrier C2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK291111.337.9214770NANA 5942Carrier C2023Diabetes 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 SHOE1620.97537.430.551570NANA 5943Carrier C2023Diabetes 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 SPL940.851111.460.731630NANA 5944Carrier C2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV850.976511.545.62830NANA 5945Carrier C2023Diabetes 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 ACCESSORIES770.779212.359.720570NANA 5946Carrier C2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH770.9871136.643340NANA 5947Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK291111.337.9214770NANA 5948Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG58117.531.416420NANA 5949Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67228DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN23110.347.88150NANA 5950Carrier C2023Diabetes Supplies and EquipCodes 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 LESS21114.425.85160NANA 5951Carrier C2023Diabetes 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 EA211741.32190NANA 5952Carrier C2023Diabetes 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 GL2011328.82180NANA 5953Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE1719.421.6890NANA 5954Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92012INTERMEDIATE EYE EXAM ESTABLISHED PATIENT14122.90140NANA 5955Carrier C2023Diabetes 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 MINS14113.326.13110NANA 5956Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2402NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE16119.275.51060NANA 5957Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER6920.002915.166.1686240NANA 5958Carrier C2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS5860.001713.934.73402460NANA 5959Carrier C2023Diabetes Supplies and EquipCodes 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 MINS14060.001414.824.97713290NANA 5960Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA24850.317211784324420semaglutideOzempic, Rybelsus 5961Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA12470.425822793612110lisdexamphetamineVyvanse 5962Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7360.7745134757310cyclosporineRestasis, Cequa 5963Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7010.59912354156860BUDESONIDE-FORMOTEROLSymbicort 5964Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6910.8292836706210rivaroxabaXARELTO 5965Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6420.553772146280liraglutideVICTOZA 5966Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6030.9436208185950empagliflozinJardiance 5967Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5800.47591668844960apixibanELIQUIS 5968Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4790.031309234760tirzepatideMOUNJARO 5969Carrier C2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3480.8851104633450adalimumab-attoAMJEVITA 5970Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3213366260LENALIDOMIDERevlamid 5971Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA22140392200enzalutamideXtandi 5972Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1910311180midazolamNayzilam 5973Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1812243150dofetilideTikosyn 5974Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA18133342160ribociclibKisqali 5975Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12128431110acalabrutinibCalquence 5976Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA111820110Epoetin AlfaEpogen, Procrit 5977Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1112352290pomalidomidePomalyst 5978Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1013534280PosaconazoleNoxafil 5979Carrier C2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9143090PirfenidoneEsbriet 5980Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1121100pegfilgrastim-jmdbFulphila 5981Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11123010lonapegsomatropin-tcgdSkytrofa 5982Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1176010darbepoetinAranesp 5983Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.594040sodium oxybateXyrem 5984Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.598040teriflunomideAubagio 5985Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.50121110selinexorXpovio 5986Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA170.3531190170calcium/magnesium/potassium/sodium oxybatesXywav 5987Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.33393030peg-filgrastimNeulasta 5988Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.3334942120ponatinibIclusig 5989Carrier C2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.333108030droxidopaNorthera 5990Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1717.20170NANA 5991Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV16126.40160NANA 5992Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY120.33334399.72100NANA 5993Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU80.87592.1080NANA 5994Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST5111.2050NANA 5995Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44205COLECTOMY LAP PART W/ REM TERM ILEUM5113.541230NANA 5996Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50360TRANSPLANTATION OF KIDNEY50.865.2050NANA 5997Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT19364BREAST RECONSTRUCTION; WITH FREE FLAP4166.3040NANA 5998Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96413CHEMO ADMIN IV INFUS SING/INITIAL SUB/DRUG UP TO *4121.741310NANA 5999Carrier D2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y40.7580.3040NANA 6000Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1717.20170NANA 6001Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV16126.40160NANA 6002Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST5111.2050NANA 6003Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44205COLECTOMY LAP PART W/ REM TERM ILEUM5113.541230NANA 6004Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364BREAST RECONSTRUCTION; WITH FREE FLAP4166.3040NANA 6005Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96413CHEMO ADMIN IV INFUS SING/INITIAL SUB/DRUG UP TO *4121.741310NANA 6006Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99404PREV MED COUNSELING IND 53-67 MIN4137040NANA 6007Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER4157.5040NANA 6008Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22551ARTHRODESIS ANT INTERBODY CERVICAL BELOW C2313586.5120NANA 6009Carrier D2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP311231210NANA 6010Carrier D2023Outpatient 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 MINS228130.9891828.41894209190NANA 6011Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES31450.993317.625.810930360NANA 6012Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE15090.993415.322.32314860NANA 6013Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT10600.99621320629980NANA 6014Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,9880.783419.274.71278610NANA 6015Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER8250.996312.834.9947310NANA 6016Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JOINT7870.764932.563.81136740NANA 6017Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74178CT ABD & PELVIS W/O CONTRST 1+ BODY REGNS6880.915714.728.42024860NANA 6018Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73718MRI LOWER EXTREMITY W/O CONTRAST6510.87116.447.8975540NANA 6019Carrier D2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL5990.844720.237.21234760NANA 6020Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY390114.123.2563340NANA 6021Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE VISIT E&M NEW PT MODERATE MDM, 45-59 MINS207115.333241830NANA 6022Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11102TANGENTIAL BIOPSY OF SKIN; FIRST LESION168112.743.231650NANA 6023Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000CYSTOURETHROSCOPY (SEP PROC)155111.929.1221330NANA 6024Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95863EMG NEEDLE 3 EXTREMITIES W/WO RELATED PARASPINAL153111.854.961470NANA 6025Carrier D2023Outpatient 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 BLCK144112.519271170NANA 6026Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17000DESTRUCT 1ST AK PREMALIG LESION141112.321.4341070NANA 6027Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66984EXTRACAPSULAR CAT REM W/ INSERT LENS PROSTHESIS; W/O ECP115115.231.2111040NANA 6028Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT94010SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW11211235.851070NANA 6029Carrier D2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64400INJ(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRIGEMINAL NRV, EA BRANCH106110.725.121850NANA 6030Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43284LAPAROSCOPY SURG, ESOPHAGEAL SPHINCTER AUGMNTATION W/DEV (IE MAGNETIC BAND)11129010NANA 6031Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77385INTENSITY MODULATED RADIATION TREATMENT DELIVERY (IMRT), SIMPLE1171010NANA 6032Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4154ENTERAL FORMULAE CATEGORY IV11132010NANA 6033Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ1559INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG1138010NANA 6034Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81204AR GENE ANALYSIS; CHARACTERIZATION OF ALLELES20.557020NANA 6035Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT30.333113.7030NANA 6036Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64582OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR40.25111040NANA 6037Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29916ARTHROSCOPY HIP W/LABRAL REPAIR90.222565.1180NANA 6038Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77522PROTON TRMT, SIMPLE W/COMP50.21878.3230NANA 6039Carrier D2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81439HEREDIT CARDIOMYOPTHY, GENOMIC ANALY PANEL MUST INCL 5 GENES50.283.6050NANA 6040Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT8600.95531.83.8957650NANA 6041Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS30413.13.1362680NANA 6042Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES1500.993319.324.241460NANA 6043Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT1130.805365.901130NANA 6044Carrier D2023Outpatient 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 MINS700.9391571690NANA 6045Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR510.882415422490NANA 6046Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY45125.80450NANA 6047Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR430.976717.30430NANA 6048Carrier D2023Outpatient 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 MINS250.88105.60250NANA 6049Carrier D2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES220.90913752.44180NANA 6050Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS30413.13.1362680NANA 6051Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY45125.80450NANA 6052Carrier D2023Outpatient 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 MINS1213617.11110NANA 6053Carrier D2023Outpatient 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 MINS8121080NANA 6054Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG2082VISIT FOR EVAL/MGMT EST PT REQ SUPERVISOIN MD, UP TO 56 MG OF ESKETAMINE NASAL, SELF ADMIM6133.5060NANA 6055Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR3131030NANA 6056Carrier D2023Outpatient 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 MINS31745030NANA 6057Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS210020NANA 6058Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAV TX W/PROTOCOL MOD, ADM BY PHYS OR QUAL PROF, EA 15 MINS11141010NANA 6059Carrier D2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES1111010NANA 6060Carrier D2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES220.0453752.44180NANA 6061Carrier D2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT1130.03565.901130NANA 6062Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE15040.956112.626.414913550NANA 6063Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE5370.998111.521475620NANA 6064Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA470112.316.2923780NANA 6065Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7034NASAL APPLICATION DEVICE3330.98813.519.523310NANA 6066Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT3210.99691618.423190NANA 6067Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR28611517.512850NANA 6068Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL1950.984612.624115800NANA 6069Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP191117.601910NANA 6070Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA1561815.911550NANA 6071Carrier D2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT1510.99345.330.156950NANA 6072Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA470112.316.2923780NANA 6073Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR28611517.512850NANA 6074Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP191117.601910NANA 6075Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA1561815.911550NANA 6076Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND149119.201490NANA 6077Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW10112714.72990NANA 6078Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH95112.26931640NANA 6079Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1902ANKLE LACE UP BRACE891170890NANA 6080Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0570DME NEBULIZE HOME/PORTABLE83114.128.715680NANA 6081Carrier D2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4205REPAIR ORTHOTIC DEV LABOR PER 15 MIN75134.733.23720NANA 6082Carrier D2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5321AK OPEN END SACH20.572.5020NANA 6083Carrier D2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1161MANUAL ADULT SIZE WHEELCHAIR, INCLUDES TILT IN SPACE50.295.2050NANA 6084Carrier D2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0861POWER WHEELCHAIR, GROUP 3 STD, MULT POWER OPTION, CAP UP TO 300 LBS50.251.2050NANA 6085Carrier D2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0005ULTRALIGHTWEIGHT WHEELCHAIR90.11196.2090NANA 6086Carrier D2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4149ENTERAL FORMULA, MANUFACT, ADM VIA ENTERAL FEED TUBE, 100 CALORIES=1UN100.18111.3280NANA 6087Carrier D2023DMECodes 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 PORTABLE730.01440.377.849240NANA 6088Carrier D2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0601CPAP DEVICE15040.00112.626.414913550NANA 6089Carrier D2023Diabetes 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 MINS4400.990917.927364040NANA 6090Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER2230.7132270.5261970NANA 6091Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS2080.855816.542.1841240NANA 6092Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN133112.924.181250NANA 6093Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK870.97711.835.160270NANA 6094Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP520.84621080.62500NANA 6095Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV47143.70470NANA 6096Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG4718.232.85420NANA 6097Carrier D2023Diabetes 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 SPL400.9518.345.97330NANA 6098Carrier D2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG360.944417.8776300NANA 6099Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN133112.924.181250NANA 6100Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV47143.70470NANA 6101Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG4718.232.85420NANA 6102Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE34136.30340NANA 6103Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4230INFUS SET INSULIN PUMP NON NEEDLE1211032.5660NANA 6104Carrier D2023Diabetes 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 MINS1114139.51100NANA 6105Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67228DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN1011039.8190NANA 6106Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA1011427.7190NANA 6107Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5501DIABETIC CUSTOM MOLDED SHOE9139.7090NANA 6108Carrier D2023Diabetes 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 EA7138.1070NANA 6109Carrier D2023Diabetes Supplies and EquipCodes 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 MINS11138010NANA 6110Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK870.01111.835.160270NANA 6111Carrier D2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER2230.0042270.5261970NANA 6112Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA15100.303314795314570semaglutideOzempic, Rybelsus 6113Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7450.42421169437020lisdexamphetamineVyvanse 6114Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3970.03531885223750tirzepatideMOUNJARO 6115Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3580.5223187583500liraglutideVICTOZA 6116Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3490.54731959103390BUDESONIDE-FORMOTEROLSymbicort 6117Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3380.932266743340empagliflozinJardiance 6118Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3220.78261341412810rivaroxabanXARELTO 6119Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3190.783785683110cyclosporineRestasis, Cequa 6120Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2750.441572402350apixibanELIQUIS 6121Carrier D2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2200712200semaglutideWegovy 6122Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA161300160DiazempamValtoco 6123Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1412451130midazolamNayzilam 6124Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12113552100LENALIDOMIDERevlamid 6125Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA101640100enzalutamideXtandi 6126Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9176090PioglitazoneActos 6127Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81280170PirfenidoneEsbriet 6128Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7147070DofetilideTikosyn 6129Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71071160cannabidiolEpidiolex 6130Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7174070pomalidomidePomalyst 6131Carrier D2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71263160PosaconazoleNoxafil 6132Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.2510904anakinraKineret 6133Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA330.0911285924BuprenorphineButrans 6134Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA140.07183014vareniclineTyrvaya Nasal Spray 6135Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA570.035190453upadacitinibRinvoq 6136Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1100.0094915105rimegepantNurtec 6137Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1630.006147021142Insuline GlargineBasaglar, Lantus, Toujeo, Semglee 6138Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA7450.004116943702LISDEXAMFETAMINEVyvanse 6139Carrier D2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA15100.0011479531457semaglutideOzempic, Rybelsus 6140Carrier F2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN1000.8321352575NANA 6141Carrier F2023Inpatient 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)1211032210NANA 6142Carrier F2023Inpatient 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)81132435NANA 6143Carrier F2023Inpatient 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)70.857114216NANA 6144Carrier F2023Inpatient 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)71102625NANA 6145Carrier F2023Inpatient 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); lumbar7132616NANA 6146Carrier F2023Inpatient 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; lumbar6132815NANA 6147Carrier F2023Inpatient 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)612206NANA 6148Carrier F2023Inpatient 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)61134733NANA 6149Carrier F2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis51163814NANA 6150Carrier F2023Inpatient 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)1211032210NANA 6151Carrier F2023Inpatient 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)81132435NANA 6152Carrier F2023Inpatient 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)71102625NANA 6153Carrier F2023Inpatient 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); lumbar7132616NANA 6154Carrier F2023Inpatient 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; lumbar6132815NANA 6155Carrier F2023Inpatient 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)612206NANA 6156Carrier F2023Inpatient 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)61134733NANA 6157Carrier F2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis51163814NANA 6158Carrier F2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63052Laminectomy, 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; single vertebral segment (List separately in addition to code for primary procedure)51183514NANA 6159Carrier F2023Inpatient 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)515605NANA 6160Carrier F2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22850Removal of posterior nonsegmental instrumentation (eg, Harrington rod)20.52302NANA 6161Carrier F2023Inpatient 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 compartment30.332103NANA 6162Carrier F2023Inpatient 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)40.2532113NANA 6163Carrier F2023Inpatient 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)50.2354023NANA 6164Carrier F2023Inpatient 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)50.232814NANA 6165Carrier F2023Inpatient 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; lumbar60.1732815NANA 6166Carrier F2023Inpatient 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)60.17134733NANA 6167Carrier F2023Inpatient 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); lumbar70.1432616NANA 6168Carrier F2023Inpatient 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)70.14102625NANA 6169Carrier F2023Inpatient 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)120.081032210NANA 6170Carrier F2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours101401NANA 6171Carrier F2023Inpatient 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 diem11301NANA 6172Carrier F2023Inpatient 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 inpatient)119101NANA 6173Carrier F2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation119101NANA 6174Carrier F2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric112201NANA 6175Carrier F2023Inpatient 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 diem11301NANA 6176Carrier F2023Inpatient 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 inpatient)119101NANA 6177Carrier F2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation119101NANA 6178Carrier F2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric112201NANA 6179Carrier F2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours101401NANA 6180Carrier F2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple3810.9738101936345NANA 6181Carrier F2023Outpatient 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)3530.9773112135318NANA 6182Carrier F2023Outpatient 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)1240.838712225119NANA 6183Carrier F2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1240.862919227117NANA 6184Carrier F2023Outpatient 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 cyclophotocoagulation1200.9206215105NANA 6185Carrier F2023Outpatient 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 technique950.87371120491NANA 6186Carrier F2023Outpatient 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 total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.920.543525882666NANA 6187Carrier F2023Outpatient 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 level890.92132975584NANA 6188Carrier F2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99205Office 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 total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.800.387528832159NANA 6189Carrier F2023Outpatient 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)790.89871974574NANA 6190Carrier F2023Outpatient 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 level57120281146NANA 6191Carrier F2023Outpatient 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)3911228435NANA 6192Carrier F2023Outpatient 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 joint2211677220NANA 6193Carrier F2023Outpatient 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)1812773117NANA 6194Carrier F2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76942Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation1813574612NANA 6195Carrier F2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9035Injection, bevacizumab, 10 mg1811958612NANA 6196Carrier F2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64634Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)1611979115NANA 6197Carrier F2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45381Colonoscopy, flexible; with directed submucosal injection(s), any substance1312435112NANA 6198Carrier F2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT91110Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report13146112112NANA 6199Carrier F2023Outpatient 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 cyclophotocoagulation1212746210NANA 6200Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15822Blepharoplasty, upper eyelid;1121201NANA 6201Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27496Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);112310NANA 6202Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36592Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified112910NANA 6203Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37248Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein1110201NANA 6204Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80069Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus inorganic (phosphate) (84100) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)112910NANA 6205Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT83615Lactate dehydrogenase (LD), (LDH);112910NANA 6206Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT84100Phosphorus inorganic (phosphate);112910NANA 6207Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT85730Thromboplastin time, partial (PTT); plasma or whole blood112910NANA 6208Carrier F2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT87497Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification112910NANA 6209Carrier F2023Outpatient 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 approach30.666711803NANA 6210Carrier F2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1610.8944184911150NANA 6211Carrier F2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem680.79412147761NANA 6212Carrier F2023Outpatient 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 session370.86493463631NANA 6213Carrier F2023Outpatient 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 education350.71432275233NANA 6214Carrier F2023Outpatient 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 management340.85293463628NANA 6215Carrier F2023Outpatient 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 management290.86213167524NANA 6216Carrier F2023Outpatient 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 plan230.86963077320NANA 6217Carrier F2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem210.85713844318NANA 6218Carrier F2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837Psychotherapy, 60 minutes with patient160.375336479NANA 6219Carrier F2023Outpatient 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 minutes160.93753042313NANA 6220Carrier F2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation101255664NANA 6221Carrier F2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG2082Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation81307053NANA 6222Carrier F2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0031Mental health assessment, by nonphysician519905NANA 6223Carrier F2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0013Esketamine, nasal spray, 1 mg512611741NANA 6224Carrier F2023Outpatient 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 minutes314203NANA 6225Carrier F2023Outpatient 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 total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.3119203NANA 6226Carrier F2023Outpatient 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 total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.3119203NANA 6227Carrier F2023Outpatient 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 hour217902NANA 6228Carrier F2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96121Neurobehavioral 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; each additional hour (List separately in addition to code for primary procedure)217902NANA 6229Carrier F2023Outpatient 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 total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.118701NANA 6230Carrier F2023Outpatient 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 patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation80.13307053NANA 6231Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous positive airway pressure (CPAP) device250.321367322NANA 6232Carrier F2023DMECodes 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 supply240.5100024NANA 6233Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable160.937541101115NANA 6234Carrier F2023DMECodes 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 accessories150.93334199114NANA 6235Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each150.93334199114NANA 6236Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device140.14291468113NANA 6237Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate100.7126010NANA 6238Carrier F2023DMECodes 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)100.987010NANA 6239Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7037Tubing used with positive airway pressure device80.1259308NANA 6240Carrier F2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis stimulator, electrical, noninvasive, other than spinal applications80.7510708NANA 6241Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108Wheelchair component or accessory, not otherwise specified718207NANA 6242Carrier F2023DMECodes with the highest percentage of approved 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-shelf717307NANA 6243Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each619006NANA 6244Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin619306NANA 6245Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCV2624Polishing/resurfacing of ocular prosthesis519905NANA 6246Carrier F2023DMECodes with the highest percentage of approved 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 minutes416704NANA 6247Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCV2628Fabrication and fitting of ocular conformer417404NANA 6248Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB4088Gastrostomy/jejunostomy tube, low-profile, any material, any type, each317703NANA 6249Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0465Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)31286812NANA 6250Carrier F2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466Home ventilator, any type, used with noninvasive interface, (e.g., mask, chest shell)317503NANA 6251Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1012Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each1110001NANA 6252Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1002Wheelchair accessory, power seating system, tilt only1110001NANA 6253Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2313Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each1110001NANA 6254Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2311Power wheelchair accessory, electronic connection between wheelchair controller and 2 or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware1110001NANA 6255Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1232Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system1111901NANA 6256Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0966Manual wheelchair accessory, headrest extension, each1111901NANA 6257Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0960Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware1111901NANA 6258Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2608Skin protection and positioning wheelchair seat cushion, width 22 in or greater, any depth1110001NANA 6259Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0860Power wheelchair, group 3 very heavy-duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds1110001NANA 6260Carrier F2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0955Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each20.58802NANA 6261Carrier F2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip470.7021960470NANA 6262Carrier F2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip470.7021960470NANA 6263Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA1980.43432.0317.82101880SEMAGLUTIDEOZEMPIC 6264Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA580.53440.0721.235530TIRZEPATIDEMOUNJARO 6265Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA530.75471.9247.878450RIMEGEPANTNURTEC 6266Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA420.809530.6468.9510320DUPILUMABDUPIXENT 6267Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA390.89741.0725.836330EVOLOCUMABREPATHA 6268Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA360.97221.849.753330EMPAGLIFLOZINJARDIANCE 6269Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA350.48570.9721.14310LIRAGLUTIDEVICTOZA 6270Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA320.31251.6321.832300TIRZEPATIDEMOUNJARO 6271Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA310.74191.6916.993280EMPAGLIFLOZINJARDIANCE 6272Carrier F2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA300.96.113.187230GALCANEZUMABEMGALITY 6273Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1811.2420.174140ERENUMABAIMOVIG 6274Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1310.1117.862110LISDEXAMFETAMINEVYVANSE 6275Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1114.6435290ETANERCEPTENBREL 6276Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA917.0211.62450ONDANSETRONONDANSETRON 6277Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA71335.39520CARIPRAZINEVRAYLAR 6278Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA512.1230.44230ACALABRUTINIBCALQUENCE 6279Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA510.1210.63230BREXPIPRAZOLEREXULTI 6280Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA514.3532.86140UBROGEPANTUBRELVY 6281Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA412.0447.14220BISMUTH-METRONIDAZOLE-TETRACYCLINEBISMUTH-METRONIDAZOLE-TETRACYCLINE 6282Carrier F2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA410.030.13130SACUBITRIL-VALSARTANENTRESTO 6283Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22842POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG130.69232782.878.511213NANA 6284Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP120.91675.359.529.97512NANA 6285Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15734MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK90.77788.530.111.6639NANA 6286Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE80.87532.243.839.4358NANA 6287Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9000INJECTION DOXORUBICIN HCL 10 MG80.752.765.555268NANA 6288Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9370VINCRISTINE SULFATE 1 MG80.87512.365.550.3268NANA 6289Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9070CYCLOPHOSPHAMIDE 100 MG70.85711.865.554.9167NANA 6290Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC70.5714777777NANA 6291Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32663THORACOSCOPY W/LOBECTOMY SINGLE LOBE70.8571347NANA 6292Carrier G2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY7122.344.741.5167NANA 6293Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY7122.344.741.5167NANA 6294Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST612.124.821156NANA 6295Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44213LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY612.721.218.1156NANA 6296Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93355ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN6123.223.266NANA 6297Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364BREAST RECONSTRUCTION W/FREE FLAP5122.122.155NANA 6298Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR5137.837.855NANA 6299Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33533CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT51159.8159.855NANA 6300Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44205LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM5125.625.655NANA 6301Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9100INJECTION CYTARABINE 100 MG511.447.319.8325NANA 6302Carrier G2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27134REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT41128.721.8134NANA 6303Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20937AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION11244.1244.111NANA 6304Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22630ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR11244.1244.111NANA 6305Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27299UNLISTED PROCEDURE PELVIS/HIP JOINT1124.124.111NANA 6306Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43645LAPS GSTR RSTCV PX W/BYP and SM INT RCNSTJ115.65.611NANA 6307Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT50546LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT1178.478.411NANA 6308Carrier G2023Inpatient 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 AGE20.535.135.122NANA 6309Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27134REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT40.25128.721.8134NANA 6310Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047LAM FACETECTOMY and FORAMOTOMY 1 VRT SGM LUMBAR70.14326.472.464.7167NANA 6311Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22853INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD170.11826.46360.911617NANA 6312Carrier G2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558ARTHRD ANT INTERBODY MIN DSC LUMBAR100.126.45955.71910NANA 6313Carrier G2023Outpatient 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 D13110.926817.314.114.83112801311NANA 6314Carrier G2023Outpatient 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 R2440.938510.510.5244244NANA 6315Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT78452MYOCARDIAL SPECT MULTIPLE STUDIES2270.933917172225227NANA 6316Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93971DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY2090.93312.812.824185209NANA 6317Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585BOTULINUM TOXIN TYPE A PER UNIT1880.781931.595.790.813175188NANA 6318Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93248EXTERNAL ECG REC GT 7D LT 15D REVIEW and INTERPRETATION1610.950311.811.82159161NANA 6319Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77334TX DEVICES DESIGN AND CONSTRUCTION COMPLEX1520.90138.3155.357.331121152NANA 6320Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77336CONTINUING MEDICAL PHYSICS CONSLTJ PR WK1470.891210.892.759.926121147NANA 6321Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93246EXTERNAL ECG REC GT 7D LT 15D RECORDING1460.965816162144146NANA 6322Carrier G2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77263THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX1450.896617.5107.281.626119145NANA 6323Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36471INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS4214242NANA 6324Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36475ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN33113233NANA 6325Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93290INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON2912929NANA 6326Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93280PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER2112121NANA 6327Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93296REM INTERROG PM/LDLS PM/IDS LT 90 D TECH REVIEW21117.832.228.612021NANA 6328Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93283PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB1911919NANA 6329Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93279PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP1711717NANA 6330Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93289INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB1711717NANA 6331Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93284PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB1611616NANA 6332Carrier G2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93288INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON1611616NANA 6333Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT13151REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM11098011NANA 6334Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT14061ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM11098011NANA 6335Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT28306OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR11020011NANA 6336Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT47001BX LVR NDL DONE PURPOSE TM OTH MAJOR PX11067011NANA 6337Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55880TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US11029011NANA 6338Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT59400OB CARE ANTEPARTUM VAG DLVR AND POSTPARTUM110863011NANA 6339Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT59409VAGINAL DELIVERY ONLY110863011NANA 6340Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT62321NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN11091011NANA 6341Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64625RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN11023011NANA 6342Carrier G2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97129THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES1105011NANA 6343Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR340.558861112.5110.913334NANA 6344Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR340.55881151153434NANA 6345Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR280.535761120.7118.612728NANA 6346Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96137PSYCL/NRPSYCL TST PHYS/QHP 2 Plus TST EA ADDL 30 MIN210.523861110.7108.312021NANA 6347Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96139PSYCL/NRPSYCL TST TECH 2 Plus TST EA ADDL 30 MIN210.6191131132121NANA 6348Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96138PSYCL/NRPSYCL TST TECH 2 Plus TST 1ST 30 MIN200.6118.1118.12020NANA 6349Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES200.784.567.870.121820NANA 6350Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96136PSYL/NRPSYCL TST PHYS/QHP 2 Plus TST 1ST 30 MIN200.5561106103.811920NANA 6351Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION180.611167.582.780.921618NANA 6352Carrier G2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY AND MNG130.846288.188.11313NANA 6353Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM5164.545.6753.2235NANA 6354Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHL AND OR RX SRVC; METHADONE ADMIN AND OR SERVICE3110310333NANA 6355Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTROCONVULSIVE THERAPY2168.568.522NANA 6356Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN1111NANA 6357Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN1111NANA 6358Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY Equal to 1 UOS1112112111NANA 6359Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0480DRUG TEST DEFINITV DR ID METH P DAY 1-7 DRUG CL114545112NANA 6360Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0011ALCOHOL and / DRUG SERVICES; ACUTE DTOX RES PROG IP111212NANA 6361Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0019BHVAL HEALTH; LONG-TERM RES W/O ROOM and BOARD-DIEM11252511NANA 6362Carrier G2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M120.916792.492.41212NANA 6363Carrier G2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES20.57.77.722NANA 6364Carrier G2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90870ELECTROCONVULSIVE THERAPY20.5747422NANA 6365Carrier G2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV and MN90.33100.4100.499NANA 6366Carrier G2023Outpatient 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 and M120.2599.299.21212NANA 6367Carrier G2023Outpatient 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 AND MNG130.2395.295.21313NANA 6368Carrier G2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT80307DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE60.1730.830.866NANA 6369Carrier G2023Outpatient 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 HOUR60.1780.980.966NANA 6370Carrier G2023Outpatient 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 MIN200.151241242020NANA 6371Carrier G2023Outpatient 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 MIN210.14119.2119.22121NANA 6372Carrier G2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT96131PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR70.1459.580.977.9167NANA 6373Carrier G2023DMECodes 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 RATE640.765618.465.648.5214364NANA 6374Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE180.555631.562.755.451318NANA 6375Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0470RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/O BACKU170.7647476.671.411617NANA 6376Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7000CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH150.466741.759.255.441115NANA 6377Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA6550WND CARE SET NEG PRSS WND TX ELEC PUMP SPL140.428641.763.458.441014NANA 6378Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS130.92318.58.51313NANA 6379Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1960AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB120.833322.122.11212NANA 6380Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS90.4444464699NANA 6381Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2625ENLARGEMENT OF OCULAR PROSTHESIS81-160.9-160.988NANA 6382Carrier G2023DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1970AFO PLASTIC WITH ANKLE JOINT CUSTOM FABRICATED80.87530.430.488NANA 6383Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4649SURGICAL SUPPLY; MISCELLANEOUS1117.817.811NANA 6384Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7524TRACHEOSTOMA STENT/STUD/BUTTON EACH1145.245.211NANA 6385Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9513LUTETIUM LU 177 DOTATATE THERAPEUTIC 1 MCI1121.621.611NANA 6386Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0261HOS BED SEMI-ELEC ANY TYPE SIDE RAIL W/O MATTRSS1170.770.711NANA 6387Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0635PATIENT LIFT ELECTRIC WITH SEAT OR SLING113.33.311NANA 6388Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0652PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS11119.8119.811NANA 6389Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0656SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK11119.8119.811NANA 6390Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0667SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG11119.8119.811NANA 6391Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC1140.140.111NANA 6392Carrier G2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1226WHLCHAIR ACCESS MANUAL FULL RECLINING BACK EACH113311NANA 6393Carrier G2023DMECodes 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 PRSS1112012011NANA 6394Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0656SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK1112012011NANA 6395Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0667SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG1112012011NANA 6396Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2624POLISHING/RESURFACING OF OCULAR PROSTHESIS130.088.58.51313NANA 6397Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA6550WND CARE SET NEG PRSS WND TX ELEC PUMP SPL140.0741.763.458.441014NANA 6398Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA7000CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH150.0741.759.255.441115NANA 6399Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE180.0631.562.755.451318NANA 6400Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1390O2 CONC 1 DEL PORT 85 PCT OR GT 02 CONC AT PRSC FLW RATE640.0218.465.648.5214364NANA 6401Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11056PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-41011NANA 6402Carrier G2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11721DEBRIDEMENT NAIL ANY METHOD 6 OR GT1011NANA 6403Carrier G2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN16119.260.242.691423NANA 6404Carrier G2023Diabetes 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 SERVICE11NANA 6405Carrier G2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT USE WITH NONDME INTRSTL CGM10NANA 6406Carrier G2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9277TRANSMITTER; EXT USE WITH NONDME INTRSTL CGM10NANA 6407Carrier G2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN16119.260.1642.691423NANA 6408Carrier G2023Diabetes 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 SERVICE11NANA 6409Carrier G2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0784EXTERNAL AMBULATORY INFUSION PUMP INSULIN2360.843.191423NANA 6410Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA13930.84913.352.3425968AMPHETAMINE/DEXTROAMPHETAMINEADDERALL 6411Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5850.81214.255.9180405METHYLPHENIDATE HCLRITALIN 6412Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4570.49918.774.5143314DEXCOM Receiver/Sensor/TransmiterDEXCOM 6413Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4310.47313.756.386345SEMAGLUTIDEOZEMPIC 6414Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3830.56422.173133250LISDEXAMFETAMINE DIMESYLATEVYVANSE 6415Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2780.52219.97995183PREGABALINLYRICA 6416Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2680.57516.962.2103165Hydrocodone/AcetaminophenNORCO 6417Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2640.59116.266.830234ADALIMUMABHUMIRA 6418Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2100.56712.365.3105105OxycodoneOXYCONTIN 6419Carrier G2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1880.7391662.166122ATOMOXETINE HYDROCHLORIDESTRATTERA 6420Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA550.89116.549.61837FILGRASTIM-SNDZZARXIO 6421Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA13930.84913.352.3425968AMPHETAMINE-DEXTROAMPHETAMINEADDERALL 6422Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA850.83511.360.92263INSULIN INFUSION DISPOSABLE PUMPOMNIPOD 10 PACK 6423Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA540.81512.465.61638ISOTRETINOINACCUTANE 6424Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5850.81214.255.9180405METHYLPHENIDATE HCLRITALIN 6425Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1430.81111.748.34895EMPAGLIFLOZINJARDIANCE 6426Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1110.79311.358.63378SACUBITRIL-VALSARTANENTRESTO 6427Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA520.7691763.12230MODAFINILPROVIGIL 6428Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA790.7599.666.91366GUANFACINE HCL (ADHD)INTUNIV 6429Carrier G2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA630.74621.358.41548GALCANEZUMAB-GNLMEMGALITY 6430Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA630.04814.667.52567SECUKINUMABCOSENTYX 6431Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA900.02217.959.12888EVOLOCUMABREPATHA 6432Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1380.02218.150.439156DUPILIMABDUPIXENT 6433Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA560.01820.351.92244VILAZODONEVIIBRYD 6434Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA590.01719.4403274DAPAGLIFLOZINFARXIGA 6435Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA600.01712.367749ERENUMAB-AOOEAIMOVIG 6436Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA600.01716.952.31651ESCITALOPRAMLEXIPRO 6437Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA620.01620.558.22463RIFAXIMINXIFAXAN 6438Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA620.01620.262.62869VENLAFAXINEEFFEXOR 6439Carrier G2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA620.0161743.9454RISANKIZUMAB-RZAASKYRIZI 6440Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN780.794924.239.71959NANA 6441Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy530.867963.7053NANA 6442Carrier H2023Inpatient 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), With410.9512456.9635NANA 6443Carrier H2023Inpatient 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 Gastroent370.864952037NANA 6444Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int310.8714873.7229NANA 6445Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom220.86362484220NANA 6446Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-Lateral,Ea Add.In180.722297.3018NANA 6447Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64999Unlisted Procedure,Nervous System130.92312482.9112NANA 6448Carrier H2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22634Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn120.91674882.9111NANA 6449Carrier H2023Inpatient 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)90.66672851.336NANA 6450Carrier H2023Inpatient 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 Fem817508NANA 6451Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11971Removal Of Tissue Expander Without Insertion Of Implant815208NANA 6452Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19371Peri-Implant Capsulectomy, Breast, Complete, Including Removal Of All Intracapsular Conten7128.807NANA 6453Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447Replacement Knee Total717507NANA 6454Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19370Revision Of Peri-Implant Capsule, Breast, Including Capsulotomy, Capsulorrhaphy, And/Or Pa5128.805NANA 6455Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue760Ancillary Services - Specialty Services-General Classification5142.345.814NANA 6456Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim417204NANA 6457Carrier H2023Inpatient 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,415404NANA 6458Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33477Transcatheter Pulmonary Valve Implantation, Percutaneous Approach, Including Pre-Stenting414804NANA 6459Carrier H2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy Simple Complete415404NANA 6460Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy53163.7053NANA 6461Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58150Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With411456.9635NANA 6462Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom2212484220NANA 6463Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33361Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem817508NANA 6464Carrier H2023Inpatient 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 Specim417204NANA 6465Carrier H2023Inpatient 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 W415404NANA 6466Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63053Laminectomy, Facetectomy, Or Foraminotomy During Posterior Interbody Arthrodesis, Lumbar;417804NANA 6467Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63048Laminectomy, Facetectomy & Foraminotomy (Unilateral Or Bilateral W/ Decompression Of Spina218402NANA 6468Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33419Transcatheter Mitral Valve Repair, Percutaneous Approach, Including Transseptal Puncture W214802NANA 6469Carrier H2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT58999Unlisted Procedure Female Genital System Nonobstetrical112401NANA 6470Carrier H2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation70.285715.455.743NANA 6471Carrier H2023Inpatient 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 diem2017.61.311NANA 6472Carrier H2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric1149.501NANA 6473Carrier H2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric1149.501NANA 6474Carrier H2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation70.285715.455.743NANA 6475Carrier H2023Inpatient 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 diem2017.61.311NANA 6476Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echo, Transthoracic W/Doppler, Complete360020.91761.35.31835984NANA 6477Carrier H2023Outpatient 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]324160.963202.4132415NANA 6478Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Mri, Lower Extremity Any Joint; Wo Contr266210.86883.57.15526566NANA 6479Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTMSMPTPhysical Therapy210690.69411NANA 6480Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri Of Lumbar Spine187890.86053.67.42018769NANA 6481Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Of Brain And Further Sequences166300.919613.84.93316597NANA 6482Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Ct Abd & Pelv W Contrast161070.9092.65.68216025NANA 6483Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity; Wo Co130810.860637.61613065NANA 6484Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri Of Cervical Spine111420.85775.37.71811124NANA 6485Carrier H2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70551Mri Of Brain96290.89094.56.5169613NANA 6486Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15772Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar57163.8057NANA 6487Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92250Fundus photography with interpretation and report2912213.2128NANA 6488Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29870Arthroscopy,Knee,Dx,W/Wo Syn.Bx2212462.9121NANA 6489Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64590I & Plcmt. Peripheral Generator/Rec171181.5017NANA 6490Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64479Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level1412271.7212NANA 6491Carrier H2023Outpatient 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)14120.675.9113NANA 6492Carrier H2023Outpatient 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 sinus14117.983.2113NANA 6493Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64484Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)13168.6013NANA 6494Carrier H2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15771Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate10182.6010NANA 6495Carrier H2023Outpatient 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, lumbar9145.380.318NANA 6496Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total1601064.31159NANA 6497Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Replacement Hip Total Simple11618633113NANA 6498Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36482Endovenous Ablation Therapy Of Incompetent Vein, Extremity, By Transcatheter Delivery Of A78171.1078NANA 6499Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36470Injection Of Sclerosant; Single Incompetent Vein (Other Than Telangiectasia)39169.7039NANA 6500Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19303Mastectomy Simple Complete381045.9236NANA 6501Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64615Chemodenervation Of Muscle(S); Muscle(S) Innervated By Facial, Trigeminal, Cervical Spinal33114.9033NANA 6502Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT17106Dest Cut Vasc Proliferative Les To 10 Sq20175.6020NANA 6503Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT19350Reconstruct Nipple/Areolar Unil17146.4017NANA 6504Carrier H2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64590I & Plcmt. Peripheral Generator/Rec171181.5017NANA 6505Carrier H2023Outpatient 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 Int918809NANA 6506Carrier H2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin2640.8814.2510.125239NANA 6507Carrier H2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor1680.910710.348.214154NANA 6508Carrier H2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica1650.88481043.112153NANA 6509Carrier H2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1350.859328.250.112123NANA 6510Carrier H2023Outpatient 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 plan1020.813732.667.9894NANA 6511Carrier H2023Outpatient 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 minutes900.833323.768.4882NANA 6512Carrier H2023Outpatient 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 minutes870.873624.269.1879NANA 6513Carrier H2023Outpatient 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 minutes790.835417.870772NANA 6514Carrier H2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem730.835618.556.3964NANA 6515Carrier H2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0032Mental health service plan development by nonphysician580.81034353256NANA 6516Carrier H2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480Intensive Outpatient Psychiatric Services Per Diem15141.6015NANA 6517Carrier H2023Outpatient 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 Health61406NANA 6518Carrier H2023Outpatient 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 Profess514.805NANA 6519Carrier H2023Outpatient 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 Or514.805NANA 6520Carrier H2023Outpatient 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 Pr514.805NANA 6521Carrier H2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours31489612NANA 6522Carrier H2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97152Behavior 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 minutes211602NANA 6523Carrier H2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870Electroconvulsive therapy (includes necessary monitoring)213.290.711NANA 6524Carrier H2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care2145.320NANA 6525Carrier H2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97154Grp Adptve Bhvior Trtmnt By Protocol, Admnstrd By Tech Under The Drction Of A Phys Or Othe11001NANA 6526Carrier H2023Outpatient 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, Includin203111.347.617186NANA 6527Carrier H2023Outpatient 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 Motor168110.348.214154NANA 6528Carrier H2023Outpatient 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 Cortica16511043.112153NANA 6529Carrier H2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS0013Esketamine, Nasal Spray, 1 Mg31116.860.61021NANA 6530Carrier H2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837Psychotherapy, 60 minutes with patient110.09141.5107.129NANA 6531Carrier H2023Outpatient 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 plan1020.0132.667.9894NANA 6532Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Adjustable, Custom Fabricated, Includes Fitting And Adjustment2580.93821.8931587NANA 6533Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified1100.818266.90110NANA 6534Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ630.936558.6063NANA 6535Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each460.913105.7145NANA 6536Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair370.891974.9037NANA 6537Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications320.3125150032NANA 6538Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr290.8621107.6029NANA 6539Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes290.620770.3128NANA 6540Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1846Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens280.535774.6028NANA 6541Carrier H2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination270.888969.3027NANA 6542Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Typ141051.7113NANA 6543Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22719607NANA 6544Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260Hospital Bed, Seimi-Electric (Head And Foot Adjustment), With Any Type718007NANA 6545Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each61106.106NANA 6546Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0040Adjustable angle footplate, each5110105NANA 6547Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0978Wheelchair accessory, positioning belt/safety belt/pelvic strap, each51117.305NANA 6548Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2613Positioning Wheelchair Back Cushion, Posterior, Width Less Than 22 Inches, Any5152.805NANA 6549Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8690Aud Osseo Dev, Int/Ext Comp5114405NANA 6550Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0261Hospital Bed, Semi-Electric (Head And Foot Adjustment), With Any Type5157.605NANA 6551Carrier H2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5856Addition To Lower Extremity Prosthesis, Endoskeletal Knee-Shin System,51110.405NANA 6552Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0486Adjustable, Custom Fabricated, Includes Fitting And Adjustment250100250NANA 6553Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0005Ultralightweight Wheelchair37174.9037NANA 6554Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2755Addition To Lower Extremity Orthosis Carbon Graphite Lamination27169.3027NANA 6555Carrier H2023DMECodes 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 Typ14151.7113NANA 6556Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2622Skin Protection Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth10161.319NANA 6557Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2613Positioning Wheelchair Back Cushion, Posterior, Width Less Than 22 Inches, Any5152.805NANA 6558Carrier H2023DMECodes 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,51110.405NANA 6559Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL5973Endoskeletal Ankle Foot System, Microprocessor Controlled Feature, Dorsiflexion3111203NANA 6560Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0825Pwc Gp 2 Hd Cap Chair114801NANA 6561Carrier H2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0483High Frequency Chest Wall Oscillation System, With Full Anterior And/Or Posterior Thoracic160.54860115NANA 6562Carrier H2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip710.66191.622.214570NANA 6563Carrier H2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip710.66191.622.214570NANA 6564Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA21500.46321.716.5325818920SEMAGLUTIDEOZEMPIC 6565Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA11440.42742.7919.414110030TIRZEPATIDEMOUNJARO 6566Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA8610.32172.6229.53767850SEMAGLUTIDEOZEMPIC 6567Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA8500.65294.4845.241666840RIMEGEPANTNURTEC ODT 6568Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA5960.739914.4856.57994970DUPILUMABDUPIXENT 6569Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4600.7376.945.241133470UBROGEPANTUBRELVY 6570Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4550.66153.5120.49484070SEMAGLUTIDEWEGOVY 6571Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4510.84481.4213.66803710EMPAGLIFLOZINJARDIANCE 6572Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4120.48793.715.51533590TIRZEPATIDEMOUNJARO 6573Carrier H2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4110.54011.717.03573540SEMAGLUTIDEOZEMPIC 6574Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA2417.855.192040ONDANSETRON HCLZOFRAN 6575Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1316.2822.35490METHYLPHENIDATECONCERTA 6576Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1110.010.01380DESVENLAFAXINE SUCCINATEDESVENLAFAXINE ER 6577Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1110.0121.41290EMPAGLIFLOZIN AND METFORMINSYNJARDY 6578Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1112.3317.18560NALTREXONEVIVITROL 6579Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1111.1233.31830ENZALUTAMIDEXTANDI 6580Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1010.0212.62190LURASIDONE HYDROCHLORIDELATUDA 6581Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA915.3814.75720LENVATINIBLENVIMA 6582Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA8110.3513.35260DEXLANSOPRAZOLEDEXILANT 6583Carrier H2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA8112.030.01260CARIPRAZINEVRAYLAR 6584Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA214.0325.49110ADALIMUMABHUMIRA 6585Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1169.77010TRAMETINIBMEKINIST 6586Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1120.47100ALPELISIBPIQRAY 6587Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA113100SECUKINUMABCOSENTYX 6588Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA111.33100ABIRATERONE ACETATEZYTIGA 6589Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1191.66010NEBIVOLOL HYDROCHLORIDEBYSTOLIC 6590Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA113.19100AMBRISENTANLETAIRIS 6591Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1120.99100TOPIRAMATETROKENDI 6592Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1167.42010DROXIDOPANORTHERA 6593Carrier H2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1173.6010MARAVIROCSELZENTRY 6594Carrier I2023Inpatient 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)60.833348.466NANA 6595Carrier I2023Inpatient 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)500.0912.514NANA 6596Carrier I2023Inpatient 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)50.830.975NANA 6597Carrier I2023Inpatient 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)400.0916.6613NANA 6598Carrier I2023Inpatient 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)401.414NANA 6599Carrier I2023Inpatient 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 ileocolostomy401.414NANA 6600Carrier I2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38562Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic400.60.4731NANA 6601Carrier I2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis401.394NANA 6602Carrier I2023Inpatient 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)30.666765.033NANA 6603Carrier I2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45330Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)300.093NANA 6604Carrier I2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44206Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)301.853NANA 6605Carrier I2023Inpatient 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; lumbar2172.212NANA 6606Carrier I2023Inpatient 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; lumbar2126.162NANA 6607Carrier I2023Inpatient 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)110.221NANA 6608Carrier I2023Inpatient 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 component110.041NANA 6609Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22808Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments112.411NANA 6610Carrier I2023Inpatient 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)1188.711NANA 6611Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31299Unlisted procedure, accessory sinuses1177.771NANA 6612Carrier I2023Inpatient 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; thoracic110.051NANA 6613Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64999Unlisted procedure, nervous system1177.771NANA 6614Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38206Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous1145.211NANA 6615Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38241Hematopoietic progenitor cell (HPC); autologous transplantation1145.211NANA 6616Carrier I2023Inpatient 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)1177.771NANA 6617Carrier I2023Inpatient 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 allograft110.381NANA 6618Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61736Laser interstitial thermal therapy of a simple single intracranial lesion1152.421NANA 6619Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27137Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft110.381NANA 6620Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63200Laminectomy, with release of tethered spinal cord, lumbar110.011NANA 6621Carrier I2023Inpatient 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; lumbar1141.271NANA 6622Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47379Unlisted laparoscopic procedure, liver1166.711NANA 6623Carrier I2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22850Removal of posterior nonsegmental instrumentation (eg, Harrington rod)110.021NANA 6624Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete2410.92953.65241NANA 6625Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1800.93335.65180NANA 6626Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT abd & pelv w contrast1620.91984.16162NANA 6627Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr1370.8546.32137NANA 6628Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI of lumbar spine1350.815.32135NANA 6629Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1000.930.013.54199NANA 6630Carrier I2023Outpatient 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)990.92933.57468992NANA 6631Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250DIAGNOSTIC CT THORAX W/O CNTRST950.88423.995NANA 6632Carrier I2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221MRI, any joint of upper extremity; wo co900.74440.1412.65189NANA 6633Carrier I2023Outpatient 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 technique890.93260.012.62188NANA 6634Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-631063NANA 6635Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93303ECHO, transthoracic, complete cng4213.7442NANA 6636Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72158MRI of lumbar spine1519.215NANA 6637Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93308ECHO, transthoracic, heart, limited1212.5512NANA 6638Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT75574CTA heart w/3d image1210.3612NANA 6639Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71275CTA chest (noncoronary)1210.3512NANA 6640Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45381Colonoscopy, flexible; with directed submucosal injection(s), any substance1110.5211NANA 6641Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74181MRI, abdomen; wo contrast material(s)1015.5410NANA 6642Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93312ECHO, transesophageal, heart, compl101010NANA 6643Carrier I2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT62323Injection(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, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)1010.198.1216191NANA 6644Carrier I2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73220MRI, upper extremity, other than joint;110.090913.9911NANA 6645Carrier I2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73700CT, lower extremity wo contrast220.045524.3422NANA 6646Carrier I2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78815Imaging PET/CT skul-thigh470.02139.6547NANA 6647Carrier I2023Outpatient 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 contr1370.01466.32137NANA 6648Carrier I2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT74177CT abd & pelv w contrast1620.01234.16162NANA 6649Carrier I2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT71260DIAGNOSTIC CT THORAX W/CONTRAST880.01144.7288NANA 6650Carrier I2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70553MRI of brain and further sequences1800.00565.65180NANA 6651Carrier I2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder4119.1142.9322NANA 6652Carrier I2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric216.842NANA 6653Carrier I2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric1166.661NANA 6654Carrier I2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder4119.1142.9322NANA 6655Carrier I2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric216.842NANA 6656Carrier I2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric1166.661NANA 6657Carrier I2023Outpatient 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 management919.089NANA 6658Carrier I2023Outpatient 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 management919.089NANA 6659Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction9136.399NANA 6660Carrier I2023Outpatient 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 session919.089NANA 6661Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours8139.8532.0117NANA 6662Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem6129.686NANA 6663Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services6113.5310.5324NANA 6664Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete6135.176NANA 6665Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318Breast reduction5128.35NANA 6666Carrier I2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-30.666703NANA 6667Carrier I2023Outpatient 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 management919.089NANA 6668Carrier I2023Outpatient 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 management919.089NANA 6669Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction9136.399NANA 6670Carrier I2023Outpatient 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 session919.089NANA 6671Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours8139.8532.0117NANA 6672Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem6129.686NANA 6673Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services6113.5310.5324NANA 6674Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete6135.176NANA 6675Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction5128.35NANA 6676Carrier I2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain2102NANA 6677Carrier I2023DMECodes 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]2780.9641.68278NANA 6678Carrier I2023DMECodes 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)80.8753.28NANA 6679Carrier I2023DMECodes 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)3103NANA 6680Carrier I2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos30.333323.723NANA 6681Carrier I2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq100.091NANA 6682Carrier I2023DMECodes 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)3103NANA 6683Carrier I2023DMECodes 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]2780.9641.68278NANA 6684Carrier I2023DMECodes 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)80.8753.28NANA 6685Carrier I2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos30.333323.723NANA 6686Carrier I2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq100.091NANA 6687Carrier I2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin2135.692NANA 6688Carrier I2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml100.091NANA 6689Carrier I2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin2135.692NANA 6690Carrier I2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml100.091NANA 6691Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA430.23265.411.51439SEMAGLUTIDEOZEMPIC, RYBELSUS 6692Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.80561.3266.59432CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, RESTASIS 6693Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3515.2439.93629ADALIMUMABHUMIRA 6694Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA310.548429.41116.08823HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN 6695Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA290.82764.522.421118OXYCODONE HCLOXYCODONE HCL, OXYCONTIN 6696Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2616.831.85719RISANKIZUMAB-RZAASKYRIZI 6697Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA220.818216.77127.82121DUPILUMABDUPIXENT, DUPIXENT DUPILUMAB 6698Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2005.1812.71515SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 6699Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA190.263213.8136.55118TIRZEPATIDEMOUNJARO 6700Carrier I2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA14148.43126.02311FREMANEZUMAB-VFRMAJOVY 6701Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3515.2439.93629ADALIMUMABHUMIRA 6702Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2616.831.85719RISANKIZUMAB-RZAASKYRIZI 6703Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA14148.43126.02311FREMANEZUMAB-VFRMAJOVY 6704Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8118.1908LIFITEGRASTXIIDRA 6705Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7136.3807GUSELKUMABTREMFYA 6706Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511.8217.0532HYDROMORPHONE HCLHYDROMORPHONE HCL 6707Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511.7739.9314RUXOLITINIB PHOSPHATE (TOPICAL)OPZELURA 6708Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA4131.2504APREMILASTOTEZLA 6709Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA417.8604FEZOLINETANTVEOZAH 6710Carrier I2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA413.5839.1422ABEMACICLIBVERZENIO 6711Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1144.1710IVABRADINE HCLCORLANOR 6712Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA115.7210RIMEGEPANT SULFATENURTEC 6713Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1192.9201UPADACITINIBRINVOQ ER 6714Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1119.6710RIBOCICLIB SUCCINATEKISQALI 6715Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1181.7501ERENUMAB-AOOEAIMOVIG 6716Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1115.6810ELAGOLIX SODIUMORILISSA 6717Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.587.6702DUPILUMABDUPIXENT, DUPIXENT DUPILUMAB 6718Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.527.4510AXITINIBINLYTA 6719Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.2522.9510EVOLOCUMABREPATHA SURECLICK 6720Carrier I2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.125283.8201RIFAXIMINXIFAXAN 6721Carrier J2023Inpatient 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)540.77784.6764.6564811NANA 6722Carrier J2023Inpatient 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 pump36015.732016NANA 6723Carrier J2023Inpatient 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)320.751.264.052306NANA 6724Carrier J2023Inpatient 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)320.781329.6567.0632910NANA 6725Carrier J2023Inpatient 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; lumbar280.821422.2675.234245NANA 6726Carrier J2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis2800.636.3424NANA 6727Carrier J2023Inpatient 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)2702.435.85522NANA 6728Carrier J2023Inpatient 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); lumbar270.851955.22274NANA 6729Carrier J2023Inpatient 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);260.03850.764.83521NANA 6730Carrier J2023Inpatient 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)250.840.146.461248NANA 6731Carrier J2023Inpatient 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)810.74102.1335NANA 6732Carrier J2023Inpatient 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 interpretation711.2160.7216NANA 6733Carrier J2023Inpatient 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)7145.897NANA 6734Carrier J2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47379Unlisted laparoscopic procedure, liver5182.335NANA 6735Carrier J2023Inpatient 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; lumbar5121.2648051NANA 6736Carrier J2023Inpatient 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)5117.615NANA 6737Carrier J2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22848Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)510.133.7914NANA 6738Carrier J2023Inpatient 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 array3137.843NANA 6739Carrier J2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63285Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical3121.673NANA 6740Carrier J2023Inpatient 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 segment31100.0335NANA 6741Carrier J2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunk31100.653NANA 6742Carrier J2023Inpatient 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 component3154.073NANA 6743Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22632Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure)11115.391NANA 6744Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)111NANA 6745Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63267Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar11115.3919211NANA 6746Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63081Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment20.561.172022NANA 6747Carrier J2023Inpatient 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; lumbar30.333345.113NANA 6748Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22216Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)30.333351.1272032NANA 6749Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22214Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar30.333357.083NANA 6750Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22630Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar70.285754.877NANA 6751Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22848Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)50.20.133.7914NANA 6752Carrier J2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22325Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar50.221.2648051NANA 6753Carrier J2023Outpatient 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 minutes54680.683124.9129.84908.88546010NANA 6754Carrier J2023Outpatient 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 flexibility51820.68218.0929.511051726NANA 6755Carrier J2023Outpatient 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 activities45210.671335.4929.66931.2645155NANA 6756Carrier J2023Outpatient 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 minutes42820.67479.8330.4842746NANA 6757Carrier J2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306ECHO, transthoracic w/doppler, complete34350.96130.23.88320234333NANA 6758Carrier J2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple29090.96363.825.94857.6125278415NANA 6759Carrier J2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI, lower extremity any joint; wo contr28310.88591.138.13444228292NANA 6760Carrier J2023Outpatient 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)25990.96044.387.188411724826NANA 6761Carrier J2023Outpatient 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 technique24810.9733.465.57712.598238316NANA 6762Carrier J2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177CT abd & pelv w contrast23150.95252.634.07604.81423015NANA 6763Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70460Contrast CAT scan of head/brain3013.9330NANA 6764Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29898Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive2410.160.051233NANA 6765Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93924Physiologic Arterial Extremity2210.7622NANA 6766Carrier J2023Outpatient 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; lumbar2010.1574.993172NANA 6767Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38222Diagnostic bone marrow; biopsy(ies) and aspiration(s)2012.3818.46317NANA 6768Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43250Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps2011.4120NANA 6769Carrier J2023Outpatient 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)1910.027.52316NANA 6770Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43254Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection1910.018.25118NANA 6771Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72196MRI, pelvis; with contrast material(s)1817.3618NANA 6772Carrier J2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76391MR elastography1810.0118NANA 6773Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72295Discography, lumbar, radiological supervision and interpretation80.250.26100.0917NANA 6774Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29873Arthroscopy, knee, surgical; with lateral release40.259.254NANA 6775Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29825Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation50.2143.815NANA 6776Carrier J2023Outpatient 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; lumbar110.18180.2677110NANA 6777Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63685Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver130.153821.7213NANA 6778Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT28297Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method80.1258.998NANA 6779Carrier J2023Outpatient 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; cervical130.076975.42134NANA 6780Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63650Percutaneous implantation of neurostimulator electrode array, epidural300.066731.2730NANA 6781Carrier J2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG0260Injection Procedure For Sacroiliac Joint; Provision Of Anesthetic, Ste520.057758.345221NANA 6782Carrier J2023Outpatient 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 nerve1230.05691.4258.431122NANA 6783Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder1100.972714.4336.123107NANA 6784Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric240.62516.9929.223213NANA 6785Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric170.941284.5317NANA 6786Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete3185.263NANA 6787Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state3185.263NANA 6788Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state3185.263NANA 6789Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra3185.263NANA 6790Carrier J2023Inpatient 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 approach3185.263NANA 6791Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple2184.382NANA 6792Carrier J2023Inpatient 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.100.091NANA 6793Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15750Flap; neurovascular pedicle101.631NANA 6794Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0019Alcohol And/Or Drug Services1001NANA 6795Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64400Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)1010.891NANA 6796Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64505Injection, anesthetic agent; sphenopalatine ganglion1010.891NANA 6797Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97605Negative 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 less than or equal to 50 square centimeters1122.431NANA 6798Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55970Intersex surgery; male to female1123.11NANA 6799Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0009Alcohol And/Or Drug Services103.731NANA 6800Carrier J2023Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT31899Unlisted procedure, trachea, bronchi1123.11NANA 6801Carrier J2023Inpatient 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)101.631NANA 6802Carrier J2023Inpatient 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 cm101.631NANA 6803Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete3185.263NANA 6804Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state3185.263NANA 6805Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state3185.263NANA 6806Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra3185.263NANA 6807Carrier J2023Inpatient 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 approach3185.263NANA 6808Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple2184.382NANA 6809Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97605Negative 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 less than or equal to 50 square centimeters1122.431NANA 6810Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55970Intersex surgery; male to female1123.11NANA 6811Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31899Unlisted procedure, trachea, bronchi1123.11NANA 6812Carrier J2023Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder1100.972714.4336.123107NANA 6813Carrier J2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71271CT THORAX LW DOSE LNG CA SCR C-3040.95393.13304NANA 6814Carrier J2023Outpatient 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; individual2490.74341.89249NANA 6815Carrier J2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueH0015Alcohol And/Or Drug Services22312.7713.029214NANA 6816Carrier J2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours1610.875822.538.852159NANA 6817Carrier J2023Outpatient 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 session1360.904410.424.639127NANA 6818Carrier J2023Outpatient 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 management1320.901511.4724.578124NANA 6819Carrier J2023Outpatient 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 management1010.891110.423.41992NANA 6820Carrier J2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueH2036Alcohol and/or other drug treatment program, per diem810.938334.881NANA 6821Carrier J2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction450.955616.6437.63144NANA 6822Carrier J2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete430.953516.6439.84142NANA 6823Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services22312.7713.029214NANA 6824Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI of brain3010.6230NANA 6825Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI of brain and further sequences1214.5212NANA 6826Carrier J2023Outpatient 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 abnormalities1013.2224.0219NANA 6827Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81243FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles1013.2221.2919NANA 6828Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes6146.886NANA 6829Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant5141.115NANA 6830Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT41899Unlisted procedure, dentoalveolar structures412.749.1713NANA 6831Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450CT, head or brain wo contrast311.023NANA 6832Carrier J2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78608Brain imaging, PET, metabolic eval3116.213NANA 6833Carrier J2023Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78608Brain imaging, PET, metabolic eval30.333316.213NANA 6834Carrier J2023DMECodes 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]42420.9432.5225242422NANA 6835Carrier J2023DMECodes 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)2040.97551.63204NANA 6836Carrier J2023DMECodes 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)950.92632.93384951NANA 6837Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos260.384668.5826NANA 6838Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable260.230845.76102.4224NANA 6839Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq1400.095.47113NANA 6840Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal120.416786.0212NANA 6841Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0861PWC gp 3 std mult pow opt s/b7132.27NANA 6842Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair605.836NANA 6843Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate6029.686NANA 6844Carrier J2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in603.916NANA 6845Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0861PWC gp 3 std mult pow opt s/b7132.27NANA 6846Carrier J2023DMECodes 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)2040.97551.63204NANA 6847Carrier J2023DMECodes 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]42420.9432.5225242422NANA 6848Carrier J2023DMECodes 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)950.92632.93384951NANA 6849Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal120.416786.0212NANA 6850Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108W/C Component-Accessory Nos260.384668.5826NANA 6851Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable260.230845.76102.4224NANA 6852Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0739Repair/svc DME non-oxygen eq1400.095.47113NANA 6853Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair605.836NANA 6854Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0040Adjustable Angle Footplate6029.686NANA 6855Carrier J2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2620WC planar back cush wd <22in603.916NANA 6856Carrier J2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin160.93759.316NANA 6857Carrier J2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml1401.12.36311NANA 6858Carrier J2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5513For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each206.142NANA 6859Carrier J2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500Diab Shoe For Density Insert206.142NANA 6860Carrier J2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4217Sterile water/saline, 500 ml100.091NANA 6861Carrier J2023Diabetes 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 supply1029.11NANA 6862Carrier J2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin160.93759.316NANA 6863Carrier J2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml1401.12.36311NANA 6864Carrier J2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5513For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each206.142NANA 6865Carrier J2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5500Diab Shoe For Density Insert206.142NANA 6866Carrier J2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4217Sterile water/saline, 500 ml100.091NANA 6867Carrier J2023Diabetes 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 supply1029.11NANA 6868Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7690.312122.0443.29104665SEMAGLUTIDEOZEMPIC, RYBELSUS 6869Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5150.93598.7246.22128387ADALIMUMABHUMIRA 6870Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5060.33215.0337.970436TIRZEPATIDEMOUNJARO 6871Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3560.685415.7767.87112244HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN 6872Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3350.0066.0314.9333302SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 6873Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3250.85549.0840.3936289CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, RESTASIS, VEVYE 6874Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3030.848248.9377.663240DUPILUMABDUPIXENT, DUPIXENT DUPILUMAB 6875Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2890.716313.6847.47111178OXYCODONE HCLOXYCODONE HCL, OXYCONTIN 6876Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2220.292815.1686.2849173RIFAXIMINXIFAXAN 6877Carrier J2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2180.86742.9990.4183135GALCANEZUMAB-GNLMEMGALITY 6878Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA28125.0633.74919ABATACEPTORENCIA 6879Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2413.5335.411014LEVALBUTEROL TARTRATELEVALBUTEROL TARTRATE, XOPENEX 6880Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA24110.7754.22618LISDEXAMFETAMINE DIMESYLATELISDEXAMFETAMINE DIMESYLATE, VYVANSE 6881Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1218.4186.9739NALOXEGOL OXALATEMOVANTIK 6882Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1012.3113.8237FLUOXETINE HCLFLUOXETINE HCL 6883Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA813.76275.7444ELAGOLIX SODIUMORILISSA 6884Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA818.129.2162CARBIDOPA-LEVODOPARYTARY 6885Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA712.551.5261ACALABRUTINIB MALEATECALQUENCE 6886Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA717.011.2625BIMEKIZUMAB-BKZXBIMZELX 6887Carrier J2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA711.467.4516CONTINUOUS GLUCOSE SYSTEM SENSORDEXCOM, FREESTYLE LIBRE 6888Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA114.0510LUMATEPERONE TOSYLATECAPLYTA 6889Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1130.0710METYROSINEMETYROSINE 6890Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11238.5801SARILUMABKEVZARA 6891Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1113.3610CANNABIDIOLEPIDIOLEX 6892Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA111.7910GOLIMUMABSIMPONI 6893Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11160.7801RITLECITINIB TOSYLATELITFULO 6894Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.66679.4520LENVATINIB MESYLATELENVIMA 6895Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.66672.3280.9411ABEMACICLIBVERZENIO 6896Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.624.45165.4521RISANKIZUMAB-RZAA (CROHN'S)SKYRIZI 6897Carrier J2023Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.559.9602DIROXIMEL FUMARATEVUMERITY 6898Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY5135.905NANA 6899Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY5120.362.332NANA 6900Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT55866LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT30.666787.703NANA 6901Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44145COLECTOMY PRTL W/COLOPROCTOSTOMY2119.940.511NANA 6902Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT49255OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX2119.940.511NANA 6903Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58720SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX2140.702NANA 6904Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES21103.102NANA 6905Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11043DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<1140.510NANA 6906Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT11046DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM1140.510NANA 6907Carrier L2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT14301ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM1135.905NANA 6908Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43775LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY5120.362.332NANA 6909Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY5119.940.511NANA 6910Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44145COLECTOMY PRTL W/COLOPROCTOSTOMY2119.940.511NANA 6911Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49255OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX2140.702NANA 6912Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58720SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX21103.102NANA 6913Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES2140.510NANA 6914Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11043DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<1140.510NANA 6915Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11046DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM113.501NANA 6916Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT14301ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM113.501NANA 6917Carrier L2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15756FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST11NANA 6918Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21085IMPRESSION & PREPARATION ORAL SURGICAL SPLINT16801NANA 6919Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21196RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI16801NANA 6920Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT26210EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER150.210NANA 6921Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT32555THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING14610NANA 6922Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT55970INTERSEX SURG MALE FEMALE11139.401NANA 6923Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61885INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR140.601NANA 6924Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64568OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN140.601NANA 6925Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95976ELEC ALYS IMPLT SMPL CN NPGT PRGRMG140.601NANA 6926Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95977ELEC ALYS IMPLT CPLX CN NPGT PRGRMG140.601NANA 6927Carrier L2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTC1767GENERATOR NEUROSTIMULATOR NONRECHARGEABLE140.601NANA 6928Carrier L2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure1560.884620.60156NANA 6929Carrier L2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1440.91670.18.41143NANA 6930Carrier L2023Outpatient 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 technique1200.90830.19.11119NANA 6931Carrier L2023Outpatient 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)1130.92920.182111NANA 6932Carrier L2023Outpatient 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 technologist890.640417.847.3485NANA 6933Carrier L2023Outpatient 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 21670.955223.9067NANA 6934Carrier L2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND610.655724.548.4358NANA 6935Carrier L2023Outpatient 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 risk570.859611.9057NANA 6936Carrier L2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5112051NANA 6937Carrier L2023Outpatient 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)4912.6049NANA 6938Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple5112051NANA 6939Carrier L2023Outpatient 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)4912.6049NANA 6940Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT87799IADNA NOS QUANTIFICATION EACH ORGANISM31121.8031NANA 6941Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81374HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH2912029NANA 6942Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C2710.24.5126NANA 6943Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81256HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS21115.3021NANA 6944Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52356CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT2010.12515NANA 6945Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM1810.2018NANA 6946Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93656COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION1717.761.4413NANA 6947Carrier L2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45390COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION1316.8013NANA 6948Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95810Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist890.0117.847.3485NANA 6949Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95811POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND6124.548.4358NANA 6950Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81479Unlisted molecular pathology procedure15620.60156NANA 6951Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36475ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN3864.5038NANA 6952Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT45380Colonoscopy, flexible; with biopsy, single or multiple1440.18.41143NANA 6953Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique1200.19.11119NANA 6954Carrier L2023Outpatient 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 SINUS220.000476.6022NANA 6955Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30465REPAIR NASAL VESTIBULAR STENOSIS120.08116.3012NANA 6956Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31256NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY2189.9021NANA 6957Carrier L2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTG0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk5711.9057NANA 6958Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS13046.7013NANA 6959Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028WC ACCSS MANL SWINGAWAY OTH CNTRL INTRFCE/PSTN110.454540.7108.429NANA 6960Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108OTHER ACCESSORIES509805NANA 6961Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955WC ACSS HEADREST CUSHNED FIX MOUNT HARDWARE EA40.540.7108.413NANA 6962Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0956WC ACSS LAT TRNK/HIP SUPP FIX MOUNT HARDWARE EA40.5105.704NANA 6963Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA40.2540.7100.313NANA 6964Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562HUMDIFIR HEATED USED W/POS ARWAY PRESSURE DEVICE30.666736.303NANA 6965Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0953WHEELCHAIR AC LAT THIGH/KNEE SUPP ANY TYPE EA3097.703NANA 6966Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0960WC ACSS SHLDR HRNSS/STRAPS/CHST STRAP W/TYPE MOU30.666740.7105.712NANA 6967Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE30.66674603NANA 6968Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0040ADJUSTABLE ANGLE FOOTPLATE EACH30.666740.7105.712NANA 6969Carrier L2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB3139.503NANA 6970Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS1040CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB3139.503NANA 6971Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471RAD BACKUP NON INV INTRFC NASAL/FACIAL MASK2133.602NANA 6972Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM2115.302NANA 6973Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF2143.102NANA 6974Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5301BELOW KNEE MOLD SOCKET SHIN SACH FT ENDOSKEL SYS2169.202NANA 6975Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5620ADDITION LOWER EXTREMITY TEST SOCKET BELOW KNEE2168.902NANA 6976Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5637ADDITION LOWER EXTREMITY BELOW KNEE TOTAL CONTCT2168.902NANA 6977Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5679ADD LW EXT BK/AK CSTM MOLD/PRFAB NOT W/LOCK MECH2168.902NANA 6978Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5685ADD LOW EXT PROS BELW KNEE SUSP/SEAL SLEEVE EA2168.902NANA 6979Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5910ADD ENDOSKEL SYSTEM BELOW KNEE ALIGNABLE SYSTEM2168.902NANA 6980Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8420PROSTHETIC SOCK MULTIPLE PLY BELOW KNEE BK EACH2168.902NANA 6981Carrier L2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8470PROSTHETIC SOCK SINGLE PLY FITTING BELOW KNEE EA2168.902NANA 6982Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS1346.7013NANA 6983Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1028WC ACCSS MANL SWINGAWAY OTH CNTRL INTRFCE/PSTN1140.7108.429NANA 6984Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0108OTHER ACCESSORIES597.905NANA 6985Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0953WHEELCHAIR AC LAT THIGH/KNEE SUPP ANY TYPE EA397.703NANA 6986Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0978WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA440.7100.313NANA 6987Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0747OSTOGNS STIM ELEC NONINVASV OTH THAN SP APPLIC283.702NANA 6988Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0950WHEELCHAIR ACCESSORY TRAY EACH2105.602NANA 6989Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0955WC ACSS HEADREST CUSHNED FIX MOUNT HARDWARE EA440.7108.413NANA 6990Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0956WC ACSS LAT TRNK/HIP SUPP FIX MOUNT HARDWARE EA4105.704NANA 6991Carrier L2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0466HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF113401NANA 6992Carrier L2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin1111.74.7110NANA 6993Carrier L2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS40.548.504NANA 6994Carrier L2023Diabetes 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 accessories110.101NANA 6995Carrier L2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277TRANSMITTER; EXT USE WITH NONDME INTRSTL CGM1120.901NANA 6996Carrier L2023Diabetes 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 SPL1120.901NANA 6997Carrier L2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER1072.301NANA 6998Carrier L2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin1111.74.7110NANA 6999Carrier L2023Diabetes 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 accessories110.101NANA 7000Carrier L2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277TRANSMITTER; EXT USE WITH NONDME INTRSTL CGM1120.901NANA 7001Carrier L2023Diabetes 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 SPL1120.901NANA 7002Carrier L2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS40.548.504NANA 7003Carrier L2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS448.504NANA 7004Carrier L2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER172.301NANA 7005Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA460.565281340SEMAGLUTIDEOZEMPIC, RYBELSUS 7006Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA320.750429CONTINUOUS GLUCOSE SYSTEM SENSORFREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM 7007Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA220.318201821TIRZEPATIDEMOUNJARO 7008Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA130.69230310SACUBITRIL-VALSARTANENTRESTO 7009Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA120.33331210VARENICLINE TARTRATEVARENICLINE STARTING MONTH BOX, VARENICLINE TARTRATE 7010Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA120.9167218CYCLOSPORINE (OPHTH)RESTASIS, CEQUA, CYCLOSPORINE 7011Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA110.45450611TESTOSTERONETESTOSTERONE, ANDRODERM, TESTOSTERONE PUMP, TESTIM 7012Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA110.72730139DULAGLUTIDETRULICITY 7013Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1100011SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 7014Carrier L2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA91285ADALIMUMAB, ADALIMUMAB INJ KITHUMIRA PEN, HUMIRA PEN-CD/UC/HS STARTER, HUMIRA 7015Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA460.565281340SEMAGLUTIDEOZEMPIC, RYBELSUS 7016Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA320.750429CONTINUOUS GLUCOSE SYSTEM SENSORFREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM 7017Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA120.9167218CYCLOSPORINE (OPHTH)RESTASIS, CEQUA, CYCLOSPORINE 7018Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA91285ADALIMUMAB, ADALIMUMAB INJ KITHUMIRA PEN, HUMIRA PEN-CD/UC/HS STARTER, HUMIRA 7019Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA130.69230310SACUBITRIL-VALSARTANENTRESTO 7020Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA110.72730139DULAGLUTIDETRULICITY 7021Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA220.318201821TIRZEPATIDEMOUNJARO 7022Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA70.8571035MESALAMINEDELZICOL, MESALAMINE DR, MESALAMINE ER 7023Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA80.75144LIRAGLUTIDE, LIRAGLUTIDE INJVICTOZA 7024Carrier L2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA110.45450611TESTOSTERONETESTOSTERONE, ANDRODERM, TESTOSTERONE PUMP, TESTIM 7025Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15740FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY20.5125.702NANA 7026Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15769GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC20.5125.702NANA 7027Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21196RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI20119.502NANA 7028Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30520SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF20119.502NANA 7029Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30802ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL20119.502NANA 7030Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61580CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ20.5125.702NANA 7031Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61608RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL20.5125.702NANA 7032Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT62272THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF20.5125.702NANA 7033Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64999UNLISTED PROCEDURE NERVOUS SYSTEM20125.702NANA 7034Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP2123.520NANA 7035Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9000INJECTION DOXORUBICIN HCL 10 MG2123.520NANA 7036Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9208INJECTION IFOSFAMIDE 1 G2123.520NANA 7037Carrier K2023Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9209INJECTION MESNA 200 MG2123.520NANA 7038Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP2123.520NANA 7039Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9000INJECTION DOXORUBICIN HCL 10 MG2123.520NANA 7040Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9208INJECTION IFOSFAMIDE 1 G2123.520NANA 7041Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9209INJECTION MESNA 200 MG2123.520NANA 7042Carrier K2023Inpatient 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�111801NANA 7043Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19364Breast reconstruction; with free flap111801NANA 7044Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH1117.510NANA 7045Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33427VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING11138.901NANA 7046Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33477TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH1194.601NANA 7047Carrier K2023Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58720SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX1173.601NANA 7048Carrier K2023Inpatient 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�11215.601NANA 7049Carrier K2023Inpatient 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)11215.601NANA 7050Carrier K2023Inpatient 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.11215.601NANA 7051Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21196RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI2119.502NANA 7052Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30520SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF20.5119.502NANA 7053Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30802ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL2119.502NANA 7054Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64999UNLISTED PROCEDURE NERVOUS SYSTEM2125.702NANA 7055Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21121GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE1141.601NANA 7056Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21146RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS197.301NANA 7057Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21147RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS1141.601NANA 7058Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT38724CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ147.310NANA 7059Carrier K2023Inpatient 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 ARTERY2125.702NANA 7060Carrier K2023Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15769GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC2125.702NANA 7061Carrier K2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure510.803920.5051NANA 7062Carrier K2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple460.934827.56.3145NANA 7063Carrier K2023Outpatient 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 technique420.92866.9042NANA 7064Carrier K2023Outpatient 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)400.9258.7040NANA 7065Carrier K2023Outpatient 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 technologist320.84380.120.7131NANA 7066Carrier K2023Outpatient 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 21250.9633.6025NANA 7067Carrier K2023Outpatient 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 risk190.842114.1019NANA 7068Carrier K2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64493NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL18116.6018NANA 7069Carrier K2023Outpatient 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 forceps170.94123.5017NANA 7070Carrier K2023Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64483NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL16183016NANA 7071Carrier K2023Outpatient 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 LEVEL18116.6018NANA 7072Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64483NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL16183016NANA 7073Carrier K2023Outpatient 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)1110.1011NANA 7074Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple910.109NANA 7075Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000CYSTOURETHROSCOPY9125.409NANA 7076Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58558HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C914.809NANA 7077Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38525BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE6111.210.424NANA 7078Carrier K2023Outpatient 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)610.206NANA 7079Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52356CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT610.10.115NANA 7080Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58563HYSTEROSCOPY ENDOMETRIAL ABLATION6111.806NANA 7081Carrier K2023Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64484NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL6140.906NANA 7082Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81479Unlisted molecular pathology procedure5120.5051NANA 7083Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95810Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist320.030.120.7131NANA 7084Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31276NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS4132.204NANA 7085Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31257NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY613106NANA 7086Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT31256NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY7112.307NANA 7087Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0340UONC PAN CANCER ANALYSIS MRD FROM PLASMA395.403NANA 7088Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30117EXCISION/DESTRUCTION INTRANASAL LESION INT APPR30.33130.203NANA 7089Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT14060ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<5101.605NANA 7090Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21085IMPRESSION & PREPARATION ORAL SURGICAL SPLINT5110.105NANA 7091Carrier K2023Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT30465REPAIR NASAL VESTIBULAR STENOSIS699.306NANA 7092Carrier K2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499Chiropractic Care420.99642NANA 7093Carrier K2023Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99499Therapy Care2220.996222NANA 7094Carrier K2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499Chiropractic Care420.99642NANA 7095Carrier K2023Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99499Therapy Care2220.996222NANA 7096Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB4134.104NANA 7097Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0766Electrical stimulation device used for cancer treatment, includes all accessories, any type3148.303NANA 7098Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471RAD BACKUP NON INV INTRFC NASAL/FACIAL MASK20.51.795.711NANA 7099Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV2110.802NANA 7100Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0978WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA20.562.611NANA 7101Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE214702NANA 7102Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1833KNEE ORTHOSIS ADJUSTABLE JOINT RIGD SUPP PREFAB20104.502NANA 7103Carrier K2023DMECodes 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 unit10134.101NANA 7104Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCB9998NOC FOR ENTERAL SUPPLIES10134.101NANA 7105Carrier K2023DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC1192.401NANA 7106Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS1040CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB4134.104NANA 7107Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766Electrical stimulation device used for cancer treatment, includes all accessories, any type3148.303NANA 7108Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV2110.802NANA 7109Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE214702NANA 7110Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC1192.401NANA 7111Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510SPCH GEN DEVC SYNTHESIZD MX METH MESS&DEVC ACCSS1128.701NANA 7112Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0108OTHER ACCESSORIES1196.601NANA 7113Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0739REPR/SRVC DME NOT O2 RQR TECH CMPNT PER 15 MINS1196.601NANA 7114Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL0457TLSO FLX SC JUNC TERM INF TO SCAP SPINE PREFAB1138.901NANA 7115Carrier K2023DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1843KNEE ORTHOSIS SINGLE UPRIGHT THIGH & CALF PREFAB1189.901NANA 7116Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL1833KNEE ORTHOSIS ADJUSTABLE JOINT RIGD SUPP PREFAB2104.502NANA 7117Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0471RAD BACKUP NON INV INTRFC NASAL/FACIAL MASK21.795.711NANA 7118Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0978WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA262.602NANA 7119Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCB4149Enteral 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 unit1134.101NANA 7120Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCB9998NOC FOR ENTERAL SUPPLIES1134.101NANA 7121Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1399DURABLE MEDICAL EQUIPMENT MISCELLANEOUS172.201NANA 7122Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL1845KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF PREFAB1150.401NANA 7123Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL1960AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB11160.601NANA 7124Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2330ADD LOW EXT LACER MOLD PT MDL CSTM ORTHOSIS ONLY1160.601NANA 7125Carrier K2023DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2350ADD LOW EXTREM PROSTHETIC TYPE SOCKT MOLD PT MDL1160.601NANA 7126Carrier K2023Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin2114.102NANA 7127Carrier K2023Diabetes 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 SPL1096.701NANA 7128Carrier K2023Diabetes 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 accessories110.201NANA 7129Carrier K2023Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin2114.102NANA 7130Carrier K2023Diabetes 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 accessories110.201NANA 7131Carrier K2023Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA9276SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL196.701NANA 7132Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA750.38676867SEMAGLUTIDEOZEMPIC, RYBELSUS 7133Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3600336SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 7134Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA290.724101618LISDEXAMFETAMINE DIMESYLATEVYVANSE, LISDEXAMFETAMINE DIMESYLATE 7135Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA240.62531220CONTINUOUS GLUCOSE SYSTEM SENSORFREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM 7136Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA200.1527819TIRZEPATIDEMOUNJARO 7137Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA190.52631416DULAGLUTIDETRULICITY 7138Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA170.764711111ADALIMUMAB INJ KIT, ADALIMUMABHUMIRA PEN, HUMIRA PEN-PS/UV STARTER, HUMIRA 7139Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA160.187511515VARENICLINE TARTRATEVARENICLINE STARTING MONTH BOX, VARENICLINE TARTRATE, CHANTIX STARTING MONTH PAK 7140Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA130.4615588AMPHETAMINE-DEXTROAMPHETAMINEMYDAYIS, ADDERALL, AMPHETAMINE/DEXTROAMPHETAMINE 7141Carrier K2023Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1100211LIRAGLUTIDE (WEIGHT MANAGEMENT)SAXENDA 7142Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA750.38676867SEMAGLUTIDEOZEMPIC, RYBELSUS 7143Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA290.724101618LISDEXAMFETAMINE DIMESYLATEVYVANSE, LISDEXAMFETAMINE DIMESYLATE 7144Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA240.62531220CONTINUOUS GLUCOSE SYSTEM SENSORFREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM 7145Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA170.764711111ADALIMUMAB, ADALIMUMAB INJ KITHUMIRA PEN, HUMIRA PEN-PS/UV STARTER, HUMIRA 7146Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA190.52631416DULAGLUTIDETRULICITY 7147Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA130.4615588AMPHETAMINE-DEXTROAMPHETAMINEMYDAYIS, ADDERALL, AMPHETAMINE/DEXTROAMPHETAMINE 7148Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA70.85710233INSULIN INFUSION DISPOSABLE PUMPOMNIPOD DASH PODS (GEN 4), OMNIPOD 5 G6 INTRO KIT (GEN 5), OMNIPOD 5 G6 PODS (GEN 5) 7149Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA51173MORPHINE SULFATEMORPHINE SULFATE ER 7150Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA100.51136TESTOSTERONETESTOSTERONE, TESTOSTERONE PUMP, TESTIM 7151Carrier K2023Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA60.8333076LINACLOTIDELINZESS 7152Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20930ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED160.526.76278100.4024115NANA 7153Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD150.333326.76278107.1667114NANA 7154Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT20936AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION130.76927.578055113.4715112NANA 7155Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANTERIOR INTERBODY LUMBAR120.166726.7627886.34995111NANA 7156Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612ARTHRD PST TQ 1NTRSPC LUMBAR120.333326.7627879.453111NANA 7157Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS11110.257226.650667110NANA 7158Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614ARTHRD PST TQ 1NTRSPC EA ADD110.363617.17778100.858429NANA 7159Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61781STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL1110.35525.17664110NANA 7160Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY1011.09754.56626619NANA 7161Carrier M2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990MICROSURG TQS REQ USE OPERATING MICROSCOPE100.933.07558010NANA 7162Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS11110.257226.650667110NANA 7163Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61781STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL1110.35525.17664110NANA 7164Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY1011.09754.56626619NANA 7165Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44207LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST1011.018.05385819NANA 7166Carrier M2024Inpatient 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 video10113.22289010NANA 7167Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61510CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR810.58444455.32884917NANA 7168Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43775LAP SLEEVE GASTRECTOMY8157.646608NANA 7169Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50543LAPAROSCOPY SURG PARTIAL NEPHRECTOMY615.8646306NANA 7170Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP6112.2933339.6232433NANA 7171Carrier M2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61624TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS4123.38545.4865322NANA 7172Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20939BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY4026.7627827.5498113NANA 7173Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63047LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR30.333326.7627897.8812NANA 7174Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT20937AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION30127.308903NANA 7175Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT63053LAM FACTC/FRMT ARTHRD LUM EA20.593.2287402NANA 7176Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT53410URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA20.5101.502802NANA 7177Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27280ARTHR SI JT OPN B1GRF INSTRM2023.4848602NANA 7178Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23472ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER1043.052501NANA 7179Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22533ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR1151.4016701NANA 7180Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS2900ROBOTIC SURGICAL SYSTEM1075.5230601NANA 7181Carrier M2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21497INTERDENTAL WIRING OTHER THAN FRACTURE10168.392801NANA 7182Carrier M2024Outpatient 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 material9530.823350289250NANA 7183Carrier M2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Computed tomography, abdomen and pelvis; with contrast material(s)8030.865460747290NANA 7184Carrier M2024Outpatient 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 sequences7040.890280176870NANA 7185Carrier M2024Outpatient 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 material7040.653630156890NANA 7186Carrier M2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260Computed tomography, thorax, diagnostic; with contrast material(s)4590.8413470244350NANA 7187Carrier M2024Outpatient 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)4520.677610174350NANA 7188Carrier M2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material4190.673940144050NANA 7189Carrier M2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70486Computed tomography, maxillofacial area; without contrast material3890.852030053840NANA 7190Carrier M2024Outpatient 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; bilateral3650.761066073580NANA 7191Carrier M2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250Computed tomography, thorax, diagnostic; without contrast material3450.761367073380NANA 7192Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43239UPPER NDSC BIOPSY SINGLE/MULTIPLE172131.554440172NANA 7193Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43235UPPER GI NDSC DX W/WO COLLECTION SPECIMEN16216.0667590162NANA 7194Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43251UPR GI NDSC RMVL TUM POLYP/OTH LES SNARE TQ3018.463657030NANA 7195Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99417PROLNG OP E/M EACH 15 MIN30118.04383030NANA 7196Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43248UPR GI NDSC INSJ GUIDE WIRE DILAT ESOPHAGUS2917.726743029NANA 7197Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52356CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT28128.08507028NANA 7198Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43249UPR GI NDSC BALLOON DILAT ESOPH <30 MM DIAM28112.11938028NANA 7199Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT69436TYMPANOSTOMY GENERAL ANESTHESIA26112.2081026NANA 7200Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37765STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS24117.09997024NANA 7201Carrier M2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58322ARTIFICIAL INSEMINATION INTRA-UTERINE24135.0264024NANA 7202Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37227Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed1120100NANA 7203Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64495Injection(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)20.550010NANA 7204Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT78814Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)20.5780010NANA 7205Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT77021Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation20.51410010NANA 7206Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT75635Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing30.33790010NANA 7207Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73719Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)30.33490010NANA 7208Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73225Magnetic resonance angiography, upper extremity, with or without contrast material(s)30.3310870010NANA 7209Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70481Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)40.2510010NANA 7210Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93454Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation40.25900010NANA 7211Carrier M2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT89346STORAGE PER YEAR OOCYTE90.111174.292563.6514218NANA 7212Carrier M2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAChemical Dependency Residential Treatment Facility22122.50810.250671012NANA 7213Carrier M2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMental Health Inpatient1511.5608332.576795213NANA 7214Carrier M2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANAMental Health Residential Treatment Facility40.560.4742613.5119431NANA 7215Carrier M2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearNANADetoxification310.157222203NANA 7216Carrier M2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAChemical Dependency Residential Treatment Facility22122.50810.250671012NANA 7217Carrier M2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMental Health Inpatient1511.5608332.576795213NANA 7218Carrier M2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADetoxification40.560.4742613.5119431NANA 7219Carrier M2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAMental Health Residential Treatment Facility310.157222203NANA 7220Carrier M2024Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMental Health Residential Treatment Facility40.560.4742613.5119431NANA 7221Carrier M2024Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAChemical Dependency Residential Treatment Facility22122.50810.250671012NANA 7222Carrier M2024Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANAMental Health Inpatient1511.5608332.576795213NANA 7223Carrier M2024Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNANADetoxification310.157222203NANA 7224Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0035MH PARTIAL HOSP TX UNDER 24H890.98880.431203716.10623386NANA 7225Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN650.984661.60067065NANA 7226Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES600.983343.69807060NANA 7227Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG540.407459.56004054NANA 7228Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97155ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN480.916782.30007048NANA 7229Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN480.416791.12401048NANA 7230Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M480.437558.95856048NANA 7231Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97156FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN460.978380.21806046NANA 7232Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN440.909179.24001044NANA 7233Carrier M2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH2036A/D TX PROGRAM, PER DIEM4110.367305510.128991031NANA 7234Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2036A/D TX PROGRAM, PER DIEM4110.367305510.128991031NANA 7235Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES20123.74197020NANA 7236Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION16136.42144016NANA 7237Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN10138.19147010NANA 7238Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99215OFFICE O/P EST HI 40 MIN7146.9427807NANA 7239Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN6146.6594906NANA 7240Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99205OFFICE O/P NEW HI 60 MIN5146.5631605NANA 7241Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96136PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN4127.8368104NANA 7242Carrier M2024Outpatient 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 MIN4127.8579204NANA 7243Carrier M2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR3136.8106503NANA 7244Carrier M2024Outpatient 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 MIN80.875135.488308NANA 7245Carrier M2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97152BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN80.875104.130708NANA 7246Carrier M2024Outpatient 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 MIN60.8333184.868706NANA 7247Carrier M2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90847FAMILY PSYCHOTHERAPY W/PATIENT PRESENT60.833360.9861606NANA 7248Carrier M2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97157MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN50.8161.086605NANA 7249Carrier M2024Outpatient 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&M480.437558.95856048NANA 7250Carrier M2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90869REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN480.416791.12401048NANA 7251Carrier M2024Outpatient 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 & MNG540.407459.56004054NANA 7252Carrier M2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0373TADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME10185.948301NANA 7253Carrier M2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0362TBEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME10185.948301NANA 7254Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2623PLASTIC EYE PROSTH CUSTOM11119.029201NANA 7255Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0766Elec stim cancer treatment1170.7347301NANA 7256Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2365U1 SEALED LEADACID BATTERY119.83333301NANA 7257Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0831PWC GP2 STD SEAT ELEVATE CAP119.83333301NANA 7258Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0955CUSHIONED HEADREST1116.5658301NANA 7259Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1007PWR SEAT COMBO W/SHEAR1120.6983301NANA 7260Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2300PWR SEAT ELEVATION SYS1116.5433301NANA 7261Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0973W/CH ACCESS DET ADJ ARMREST119.83333301NANA 7262Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTV2628FABRICATION & FITTING11119.044201NANA 7263Carrier M2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1028W/C MANUAL SWINGAWAY119.83333301NANA 7264Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTV2623PLASTIC EYE PROSTH CUSTOM11119.029201NANA 7265Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0766Elec stim cancer treatment1170.7347301NANA 7266Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2365U1 SEALED LEADACID BATTERY119.83333301NANA 7267Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0831PWC GP2 STD SEAT ELEVATE CAP119.83333301NANA 7268Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0955CUSHIONED HEADREST1116.5658301NANA 7269Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1007PWR SEAT COMBO W/SHEAR1120.6983301NANA 7270Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2300PWR SEAT ELEVATION SYS1116.5433301NANA 7271Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0973W/CH ACCESS DET ADJ ARMREST119.83333301NANA 7272Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTV2628FABRICATION & FITTING11119.044201NANA 7273Carrier M2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1028W/C MANUAL SWINGAWAY119.83333301NANA 7274Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2623PLASTIC EYE PROSTH CUSTOM11119.029201NANA 7275Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0766Elec stim cancer treatment1170.7347301NANA 7276Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2365U1 SEALED LEADACID BATTERY119.83333301NANA 7277Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0831PWC GP2 STD SEAT ELEVATE CAP119.83333301NANA 7278Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0955CUSHIONED HEADREST1116.5658301NANA 7279Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1007PWR SEAT COMBO W/SHEAR1120.6983301NANA 7280Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2300PWR SEAT ELEVATION SYS1116.5433301NANA 7281Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0973W/CH ACCESS DET ADJ ARMREST119.83333301NANA 7282Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTV2628FABRICATION & FITTING11119.044201NANA 7283Carrier M2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE1028W/C MANUAL SWINGAWAY119.83333301NANA 7284Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6650.59855.524.8101265390Ozempic (0.25 or 0.5 MG/DOSE) 2MG/3ML SC SOPNOZEMPIC 7285Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6250.353610.254.70895360Wegovy (semaglutide injection)WEGOVY 7286Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4930.33068.42.330604330Zepbound Injection (tirzepatide)ZEPBOUND 7287Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4170.56357.23.20803370Mounjaro (tirzepatide)MOUNJARO 7288Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3360.750.83.910602760Testosterone Cypionate 200MG/ML IM SOLNTESTOSTERONE 7289Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2360.88982.760362000Omeprazole 20MG OR CPDROMEPRAZOLE 7290Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2190.74895.640192000Tacrolimus 0.1% OintmentTACROLIMUS 7291Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2140.789712.7519.910321820Dupixent Syn 300DUPIXENT 7292Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1890.89420.524.20461430Jardiance 25MG OR TABSJARDIANCE 7293Carrier M2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1720.70359.418.130511210Amphetamine-Dextroamphetamine 30mgAMPHETAMINE-DEXTROAMPHETAMINE 7294Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA13160850Buprenorphine 7.5MCG/HR TD PTWKBUPRENORPHINE 7295Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1110470Synjardy XR 25-1000MG OR TB24SYNJARDY 7296Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA101240820SpravatoSPRAVATO 7297Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010280KesimptaKESIMPTA 7298Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010550Acetaminophen-Codeine 300-30MG OR TABSACETAMINOPHEN-CODEINE 7299Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1010100Tazarotene 0.1% EX CREATAZAROTENE 7300Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA914890180RABEprazole Sodium 20MG OR TBECRABEPRAZOLE 7301Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA910360RevlimidREVLIMID 7302Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA813080Aklief 0.005% EX CREAAKLIEF 7303Carrier M2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71240160HizentraHIZENTRA 7304Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10112524.62024770Budesonide-Formoterol 160-4.5mcg/act InhalerBUDESONIDE-FORMOTEROL 7305Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA41113.0913.6011300EpinephrineEPINEPHRINE 7306Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA39115.4808310Stelara SQ 90mgSTELARA 7307Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA611145.84024370Fluticasone Propionate HFAFLUTICASONE 7308Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA42111.2910.56017250VilazodoneVILAZODONE 7309Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA910360Methylphenidate PatchMETHYLPHENIDATE 7310Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA13915.332.360271120Nurtec ODT 75mg (rimegepant)NURTEC 7311Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA17102150Triamcinolone 0.1% OintmentTRIAMCINOLONE 7312Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA21480110Methotrexate 25mg/mL InjectionMETHOTREXATE 7313Carrier M2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA7180160Bydureon BCise (exenatide)BYETTA 7314Carrier A2024Inpatient 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)100.842.4006666710NANA 7315Carrier A2024Inpatient 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)90.777839.851450629NANA 7316Carrier A2024Inpatient 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); lumbar90.777839.851450629NANA 7317Carrier A2024Inpatient 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)50.667.119944445NANA 7318Carrier A2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61783Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure)500.7295NANA 7319Carrier A2024Inpatient 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)501.4015NANA 7320Carrier A2024Inpatient 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)415.7658333334NANA 7321Carrier A2024Inpatient 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)4122.02895833417.969343142NANA 7322Carrier A2024Inpatient 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)3121.936851853NANA 7323Carrier A2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50360Renal allotransplantation, implantation of graft; without recipient nephrectomy300.0100925933NANA 7324Carrier A2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion3121.967314813NANA 7325Carrier A2024Inpatient 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; lumbar3136.496018523NANA 7326Carrier A2024Inpatient 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)415.7658333334NANA 7327Carrier A2024Inpatient 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)4122.02895833417.969343142NANA 7328Carrier A2024Inpatient 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)3121.936851853NANA 7329Carrier A2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22830Exploration of spinal fusion3121.967314813NANA 7330Carrier A2024Inpatient 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; lumbar3136.496018523NANA 7331Carrier A2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22848Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)2111.298194442NANA 7332Carrier A2024Inpatient 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)2120.51763889417.969343122NANA 7333Carrier A2024Inpatient 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 component210.0823611112NANA 7334Carrier A2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22212Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic1118.731NANA 7335Carrier A2024Inpatient 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)1131.18305556319.608172211NANA 7336Carrier A2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27280Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed1122.305277781NANA 7337Carrier A2024Inpatient 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 segment1165.34361111417.969343112NANA 7338Carrier A2024Inpatient 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; cervical1131.18305556319.608172211NANA 7339Carrier A2024Inpatient 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)1118.731NANA 7340Carrier A2024Inpatient 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 segments1118.731NANA 7341Carrier A2024Inpatient 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 C21165.343611111NANA 7342Carrier A2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47379Unlisted laparoscopic procedure, liver114.5455555561NANA 7343Carrier A2024Inpatient 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 component110.1063888891NANA 7344Carrier A2024Outpatient 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)3550.9690.3135416675.408888889311.6373792123434NANA 7345Carrier A2024Outpatient 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 echocardiography3410.93845.597543988466.05452313411NANA 7346Carrier A2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple3390.97050.3136342595.753335882515.4680647123275NANA 7347Carrier A2024Outpatient 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 flexibility2500.8766.649204444248.331722925015NANA 7348Carrier A2024Outpatient 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 technique2480.97580.41320987728.78424802423.644290792395NANA 7349Carrier A2024Outpatient 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 minutes2280.86846.782820419172.36992322285NANA 7350Carrier A2024Outpatient 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 material2130.85452.6930555567.8362696541212NANA 7351Carrier A2024Outpatient 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 minutes2110.86266.724981569163.55562992118NANA 7352Carrier A2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Computed tomography, abdomen and pelvis; with contrast material(s)1790.9332.652892613336.01305561792NANA 7353Carrier A2024Outpatient 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 material1760.721621.30910827176NANA 7354Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78264Gastric emptying imaging study (eg, solid, liquid, or both);2211.0254040422NANA 7355Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45390Colonoscopy, flexible; with endoscopic mucosal resection1913.879517544292.0376564191NANA 7356Carrier A2024Outpatient 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 allograft1616.237187516NANA 7357Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93308Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study1010.1136111110.000648148658.0841758191NANA 7358Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70552Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)1010.11761111110NANA 7359Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74174Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing1010.01272222210NANA 7360Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78306Bone and/or joint imaging; whole body1010.00047222210NANA 7361Carrier A2024Outpatient 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)9133.320339519NANA 7362Carrier A2024Outpatient 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 wire910.015370379NANA 7363Carrier A2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT29828Arthroscopy, shoulder, surgical; biceps tenodesis9147.03518519437.466915891NANA 7364Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64628Thermal destruction of intraosseous basivertebral nerve, first 2 vertebral bodies11825.66083331NANA 7365Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64629Thermal destruction of intraosseous basivertebral nerve, each additional vertebral body11825.66083331NANA 7366Carrier A2024Outpatient 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 compartment40.2572.397638894NANA 7367Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29822Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of80.12536.13864583370.251045381NANA 7368Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64636Destruction 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)250.0428.605325NANA 7369Carrier A2024Outpatient 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 joint320.031323.0374826432NANA 7370Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT95811Polysomnography; 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 technologist340.029417.211740234NANA 7371Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29826Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure)360.02781.00083333365.06072222502.19304121312NANA 7372Carrier A2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73221Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)1570.00640.19694444522.635819091155NANA 7373Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric30.666762.945648153NANA 7374Carrier A2024Inpatient 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 approach1142.968611111NANA 7375Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state1142.968611111NANA 7376Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple1142.968611111NANA 7377Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra1142.968611111NANA 7378Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder1148.804722221NANA 7379Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state1142.968611111NANA 7380Carrier A2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete1142.968611111NANA 7381Carrier A2024Inpatient 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 approach1142.968611111NANA 7382Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state1142.968611111NANA 7383Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple1142.968611111NANA 7384Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra1142.968611111NANA 7385Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder1148.804722221NANA 7386Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state1142.968611111NANA 7387Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete1142.968611111NANA 7388Carrier A2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric30.666762.945648153NANA 7389Carrier A2024Outpatient 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)310.8713.6156182831NANA 7390Carrier A2024Outpatient 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; individual160.562538.6585763916NANA 7391Carrier A2024Outpatient 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 session120.916719.7967171712NANA 7392Carrier A2024Outpatient 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 management120.916719.7967676812NANA 7393Carrier A2024Outpatient 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 management110.909121.7751111111NANA 7394Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services7125.19158737NANA 7395Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours50.640.629166675NANA 7396Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes2147.538888892NANA 7397Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue2147.538888892NANA 7398Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT64999Unlisted procedure, nervous system2147.538888892NANA 7399Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15877Suction assisted lipectomy; trunk2122.129027782NANA 7400Carrier A2024Outpatient 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 minutes210.10472222252221NANA 7401Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete2119.791944442NANA 7402Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction2119.791944442NANA 7403Carrier A2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem20.515.266252NANA 7404Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services7125.19158737NANA 7405Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes2147.538888892NANA 7406Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissue2147.538888892NANA 7407Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64999Unlisted procedure, nervous system2147.538888892NANA 7408Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15877Suction assisted lipectomy; trunk2122.129027782NANA 7409Carrier A2024Outpatient 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 minutes210.10472222252221NANA 7410Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete2119.791944442NANA 7411Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction2119.791944442NANA 7412Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92610Evaluation of oral and pharyngeal swallowing function1116.841NANA 7413Carrier A2024Outpatient 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)1116.841NANA 7414Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78608Brain imaging, positron emission tomography (PET); metabolic evaluation110.0002777781NANA 7415Carrier A2024Outpatient 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 tip11165.53277781NANA 7416Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92526Treatment of swallowing dysfunction and/or oral function for feeding1128.902222221NANA 7417Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47000Biopsy of liver, needle; percutaneous110.0147222221NANA 7418Carrier A2024Outpatient 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)11165.53277781NANA 7419Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0004Alcohol And/Or Drug Services1145.681388891NANA 7420Carrier A2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21209Osteoplasty, facial bones; reduction11165.53277781NANA 7421Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2820.95041.814744878282NANA 7422Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate210.95240.11951058221NANA 7423Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable70.428693.470833337NANA 7424Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate710.0290873027NANA 7425Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal60.578.904444446NANA 7426Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi204.4047222222NANA 7427Carrier A2024DMECodes 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, each204.8616666672NANA 7428Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1007Wheelchair accessory, power seating system, combination tilt and recline, with manual shear reduction204.8622222222NANA 7429Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2298Complex rehabilitative power wheelchair accessory, power seat elevation system, any type204.8619444442NANA 7430Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other204.8620833332NANA 7431Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2313PWC harness, expand control204.8622222222NANA 7432Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab207.7608333332NANA 7433Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2311Power wheelchair accessory, electronic connection between wheelchair controller204.8623611112NANA 7434Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor20.53.8080555562NANA 7435Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2377Expandable controller, initl204.8620833332NANA 7436Carrier A2024DMECodes 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, each204.8618055562NANA 7437Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2624Adj skin pro/pos cus<22in204.8618055562NANA 7438Carrier A2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each204.8616666672NANA 7439Carrier A2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate710.0290873027NANA 7440Carrier A2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate210.95240.11951058221NANA 7441Carrier A2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device2820.95041.814744878282NANA 7442Carrier A2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal60.578.904444446NANA 7443Carrier A2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor20.53.8080555562NANA 7444Carrier A2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable70.428693.470833337NANA 7445Carrier A2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml100.0086111111NANA 7446Carrier A2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin102.7294444441NANA 7447Carrier A2024Diabetes 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 supply101.5897222221NANA 7448Carrier A2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml100.0086111111NANA 7449Carrier A2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin102.7294444441NANA 7450Carrier A2024Diabetes 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 supply101.5897222221NANA 7451Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1740.75868.7343.147698HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN 7452Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1380.036210.8415.1717121SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 7453Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA860.65127.013.892264SEMAGLUTIDEOZEMPIC (0.25 OR 0.5 MG/DOSE), OZEMPIC (1 MG/DOSE), OZEMPIC (2 MG/DOSE), RYBELSUS 7454Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA810.01231.894.73774TIRZEPATIDE (WEIGHT MANAGEMENT)ZEPBOUND 7455Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA740.81087.938.413341OXYCODONE HCLOXYCODONE HCL, OXYCODONE HCL ER, OXYCONTIN 7456Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA730.82193.027.85469CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, RESTASIS 7457Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA730.90416.3423.382152ADALIMUMABHUMIRA (2 PEN), HUMIRA (2 SYRINGE), HUMIRA-CD/UC/HS STARTER, HUMIRA-PSORIASIS/UVEIT STARTER 7458Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA720.56944.835.281359TIRZEPATIDEMOUNJARO 7459Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA650.78467.788.664718OXYCODONE W/ ACETAMINOPHENOXYCODONE-ACETAMINOPHEN 7460Carrier A2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA430.83729.1712.54835DUPILUMABDUPIXENT 7461Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2816.3486.82721SECUKINUMABCOSENTYX, COSENTYX SENSOREADY (300 MG), COSENTYX SENSOREADY PEN, COSENTYX UNOREADY 7462Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1715.154.53512GALCANEZUMAB-GNLMEMGALITY 7463Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1518.387.5296ETANERCEPTENBREL SURECLICK 7464Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1014.95283.8746BUPRENORPHINE HCLBELBUCA 7465Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8113.844.7135CERTOLIZUMAB PEGOLCIMZIA, CIMZIA (2 SYRINGE) 7466Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA817.756.5853FENTANYLFENTANYL 7467Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA812.027.1426TOFACITINIB CITRATEXELJANZ, XELJANZ XR 7468Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5115.483.8714LIFITEGRASTXIIDRA 7469Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA416.0704NETARSUDIL DIMESYLATE-LATANOPROSTROCKLATAN 7470Carrier A2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA417.7404DIROXIMEL FUMARATEVUMERITY 7471Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA4124.7829.1831EVOLOCUMABREPATHA SURECLICK 7472Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2112.2420ADALIMUMABHUMIRA (2 PEN) 7473Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2125.6502PENTOSAN POLYSULFATE SODIUMELMIRON 7474Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2116.5446.9911OXYCODONE W/ ACETAMINOPHENOXYCODONE-ACETAMINOPHEN 7475Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA214.5120IVABRADINE HCLCORLANOR 7476Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2147.2802ERENUMAB-AOOEAIMOVIG 7477Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1121.8101RIBOCICLIB SUCCINATEKISQALI (600 MG DOSE) 7478Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1115.710SEMAGLUTIDEOZEMPIC (0.25 OR 0.5 MG/DOSE) 7479Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1123.0801BUTORPHANOL TARTRATEBUTORPHANOL TARTRATE 7480Carrier A2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA115.4210BUPRENORPHINEBUPRENORPHINE 7481Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99231SUBSEQUENT HOSPITAL CARE160.87535.84106.8203130NANA 7482Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58150TOTAL ABDOMINAL HYSTERECOMY WITH TUBES AND OVARIES14124.73107.4402120NANA 7483Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44207LAP; COLECT PART W/COLOPROCTOST10138.7268.740550NANA 7484Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38724CERV LYMPHADENECTOMY (MODIFIED RAD NECK DISECT)100.941.8470.70550NANA 7485Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22612LUMBAR SPINE FUSION9118.780090NANA 7486Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32663SCOPE OF LUNGS WITH REMOVAL OF LOBE8128.4572.520440NANA 7487Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31622BRANCHOSCOPY W/WOUT FLUOROSCOPIC GUIDANCE70.857120.171.190160NANA 7488Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT69990USE OPER MICROSCOPE7136.0254.480250NANA 7489Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405REPLACEMENT AORTIC VALVE OPN7139.7159.820340NANA 7490Carrier B2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61781SCAN PROC CRANIAL INTRA6135.6765.020240NANA 7491Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49255OMENTECTOMY/EPIPLOECTOMY-RESEC OMENTUM (SEP PRO)1199.270010NANA 7492Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43621GASTRECTOMY TOT; W/ROUX-EN-Y RECON11290.120010NANA 7493Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61867TWST DRL BURR CRANIOT W/REC 1 ARRAY11118.320010NANA 7494Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15769HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE4187.710040NANA 7495Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61863TWST DRL BURR CRANIOT NO REC 1 ARAY2142.260020NANA 7496Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15777ACELLULAR DERM MATRIX IMPLT21117.18163.350110NANA 7497Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61700SURGERICAL TREATMENT OF SIMPLE ANEURYSM THRU THE INTRACRANIAL CAROTID ARTERY1119.030100NANA 7498Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19370OPEN PERIPROSTHETIC CAPSULOTOMY BREAST21118.3163.350110NANA 7499Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ31140.28119.210120NANA 7500Carrier B2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19371PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE21118.28163.350110NANA 7501Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0480DEFINITIVE DRUG TEST OF CLASSES 1-72160.621879.41002160NANA 7502Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0481DEFINITIVE DRUG TEST OF CLASSES 8-141790.351988.25001790NANA 7503Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0482DEFINITIVE DRUG TEST OF CLASSES 15-221760.068485.91001760NANA 7504Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0483DEFINITIVE DRUG TEST OF CLASSES 22+1750.06989.88001750NANA 7505Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810SLEEP STUDY GREATER THAN 6 YRS OLD2430.477467.3288.230112320NANA 7506Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE1830.530162.7383.990111720NANA 7507Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ2469INJECTION, PALONOSETRON HCL, 25 MCG1431112131NANA 7508Carrier B2024Outpatient 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 SETTING1020.985543.7578.82011010NANA 7509Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN1270.522750.22105.890231040NANA 7510Carrier B2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30520SEPTOPLASTY/SMR W/WO CARTIL SCORING/REPLAC W/GFT1060.990724.93102.09011050NANA 7511Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ2469INJECTION, PALONOSETRON HCL, 25 MCG14311121310NANA 7512Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ1453INJECTION, FOSAPREPITANT, 1 MG97110870NANA 7513Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ1100INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1MG56145510NANA 7514Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9217LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG3812360NANA 7515Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ3489ZOLEDRONIC ACID 1MG (ZOMETA)3611350NANA 7516Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCQ5118INJECTION BEVACIZUMAB-BVZR BIOSIMILAR 10 MG29152270NANA 7517Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9171INJECTION, DOCETAXEL, 1 MG291325240NANA 7518Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9306INJECTION, PERTUZUMAB, 1 MG29133260NANA 7519Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ2405INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG26174220NANA 7520Carrier B2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9060INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG2410240NANA 7521Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21146RECON MIDFACE LEFORT I; 2 PIECES REQ BONE GFT1175.480010NANA 7522Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT51999UNLIS LAPS PX BLDR11501.750100NANA 7523Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21147RECON MIDFACE LEFORT I; 3/MORE PIECES REQ GFT2176.50020NANA 7524Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88323CONS & REPORT REF MAT REQUIRING PREP SLIDES1188.120010NANA 7525Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT88321CONS & REPORT REF SLIDES PREP ELSEWHERE1144.50010NANA 7526Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29916HIP ARTHRO W/LABRAL REPAIR1144.030010NANA 7527Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21196RECONST LWR JAW W/ FIXATION30.666791.450030NANA 7528Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21085IMPRESS & CUST PREP; ORAL SURG SPLINT40.577.940040NANA 7529Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27702ARTHROPLASTY ANK; W/IMPLNT (TOT ANK)20.548.630020NANA 7530Carrier B2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43497TRANSORAL LOWER ESOPHAGEAL MYOTOMY20.5158.390020NANA 7531Carrier B2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY1890.970122.7249.34011880NANA 7532Carrier B2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED550.981841.6900550NANA 7533Carrier B2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY34166.96107.3902320NANA 7534Carrier B2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC11194.9100110NANA 7535Carrier B2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC11194.9100110NANA 7536Carrier B2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY34166.96107.3902320NANA 7537Carrier B2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126DETOXIFICATION BED550.981841.6900550NANA 7538Carrier B2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY1890.970122.7249.34011880NANA 7539Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM550.963669.1700550NANA 7540Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue906PROFESSIONAL FEE FOR PSYCHOLOGY370.921123.473.6201360NANA 7541Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue905INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES250.9644.4500250NANA 7542Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015IOP AL &/OR DRG SRV->=3HRS DA/3DAWK220.782622.7150.1804180NANA 7543Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912PARTIAL HOSPITALIZATION PSYCHIATRIC PROGRAM220.9545181.0700220NANA 7544Carrier B2024Outpatient 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.16170.8900160NANA 7545Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TCRANIAL MAGN STIM TX DELI130.615496.83178.1901120NANA 7546Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION USED TO IMPROVE DEPRESSION120.583396.83139.8301110NANA 7547Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869TCRAN MAGN STIM REDETEMINE120.583396.83179.4301110NANA 7548Carrier B2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR10146.4700100NANA 7549Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR110.030010NANA 7550Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2012BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR2196.280020NANA 7551Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99366TEAM CONF W/PAT BY HC PRO1142.380010NANA 7552Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYTX PT&/FAMILY 60 MINUTES110.10010NANA 7553Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue901BEHAVIORAL HEALTH TREATMENT SERVICES, ELECTROSHOCK1192.60010NANA 7554Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ELECTRIC CONVULSIVE THERAPY31107.030030NANA 7555Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96139PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN110.030010NANA 7556Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96101PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT110010NANA 7557Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0201PART HOSPITALZTION SRVC <24 HR-DIEM4179.970040NANA 7558Carrier B2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NUBHVL STATUS XM PR HR F2F W/PT INTERPJ&PREPJ110.170010NANA 7559Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE9130.94940.96103.950268870NANA 7560Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390PORTABLE OXYGEN CONCENTRATOR980.963623.99113.36010880NANA 7561Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH700.971835.95112.1502680NANA 7562Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP490.938858.21124.1503460NANA 7563Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402NEGATIVE PRESSURE WOUND PUMP3312.2398.7102310NANA 7564Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP180.7524.19164.1402160NANA 7565Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER160.875140.4800160NANA 7566Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0935PASSIVE MOTION EXERCISE DEVICE120.525.86101.7702100NANA 7567Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0466HOME VENTILATOR, USED WITH NON-INVASIVE INTERFACE (MASK, CHEST SHELL)10127.65123.540460NANA 7568Carrier B2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0483HF CW OS SYS FULL THOR REG RECV SIM EXT OS EA100.6158.5400100NANA 7569Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9273COLD/HOT FL BTL ICE CAP/C HEAT AND/ COLD WRAP ANY11053.650010NANA 7570Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2300POWER WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM110119.350010NANA 7571Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1392PORTABLE OXYGEN CONCENTRATOR11096.633333330010NANA 7572Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9002ENTERAL NUTRITION INFUSION PUMP WITH ALARM1100.0027777780010NANA 7573Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2609CUSTOM FABRICATED WHEELCHAIR SEAT CUSHION SIZE11074.450010NANA 7574Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCB9004PARENTERAL NUTRITION INFUSION PUMP PORTABLE11053.966666670010NANA 7575Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2343PWER WHEELCHAIR ACC NONSTANDARD SEAT FRAME DEPTH, 20-25 INCHES110149.46666670010NANA 7576Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0261HOSPITAL BED SEMI-ELECTRIC WITH ANY RAILS AND WITHOUT MATTRESS11046.550010NANA 7577Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0766ELEC STIM CANCER TREATMENT1155.6333333300100NANA 7578Carrier B2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0277POWERED PRESS-REDUCING AIR MATRESS11067.583333330010NANA 7579Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0606AUTOMATIC EXTRNL DFBRLLTR, W INTGRTD ELECRDGRM ANALYSIS30.333369.1166666796.1750120NANA 7580Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER160.1250140.479166700160NANA 7581Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2402NEGATIVE PRESSURE WOUND PUMP330.02942.22986111198.7054928302310NANA 7582Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4239CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH700.028235.95112.145044902680NANA 7583Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0470BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP490.020458.21111111124.150839403460NANA 7584Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0601CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE9130.01740.96410256103.94863430268870NANA 7585Carrier B2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE1390PORTABLE OXYGEN CONCENTRATOR980.009123.98666667113.357178010880NANA 7586Carrier B2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN300.96670111.8100300NANA 7587Carrier B2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY2810120.4800280NANA 7588Carrier B2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING100.83330101.9200100NANA 7589Carrier B2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY1104.50010NANA 7590Carrier B2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9276DISPOSABLE SENSOR FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY1104.50010NANA 7591Carrier B2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY2810120.4800280NANA 7592Carrier B2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN300.96670111.8100300NANA 7593Carrier B2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9278EXTERNAL RECEIVER FOR CONTINOUS GLUCOSE MONITORING100.83330101.9200100NANA 7594Carrier B2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN300.03330111.8100300NANA 7595Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA22420.839003621880SemaglutideOzempic 7596Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA8180.3020198720Clobetasol PropionateClobetasol 7597Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5600.710701131429Lisdexamfetamine DimesylateLisdexamfeta 7598Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4880.323801123365PregabalinPregabalin 7599Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4780.937200105373DulaglutideTrulicity 7600Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4670.69380090377LiraglutideVictoza 7601Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4510.48120132419TretinoinTretinoin 7602Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4150.930101132283Hydrocodone-AcetaminophenHydroco/apap 7603Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4120.66260370342Continuous Glucose System SensorFreesty Libr 7604Carrier B2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3230.77401107216AdalimumabHumira Pen 7605Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA361011521Insulin DegludecIns Degl Flx 7606Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA29130254AbemaciclibVerzenio 7607Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA27100819Sodium Zirconium CyclosilicateLokelma 7608Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA25101916Insulin AspartInsulin Aspa 7609Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA16120133Lenvatinib MesylateLenvima 7610Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1611288OlaparibLynparza 7611Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA16102511Dextromethorphan Hydrobromide-Bupropion HydrochlorideAuvelity 7612Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA11101110Segesterone Acetate-Ethinyl EstradiolAnnovera 7613Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1011182LenalidomideRevlimid 7614Carrier B2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1011064MetronidazoleMetronidazol 7615Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)12124.3149.63111NANA 7616Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633Filter, disposable, used with positive airway pressure device9124.316818NANA 7617Carrier O2024Inpatient 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)80.87510.2360.0444NANA 7618Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22840Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)7139.237NANA 7619Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63052LAMINECTOMY, 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; SINGLE VERTEBRAL SEGMENT7124.3157.6516NANA 7620Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44213Filter, disposable, used with positive airway pressure device70.85717.8746.0852NANA 7621Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63048Room & Board Semiprivate (Two Beds)-Psychiatric6124.363.2515NANA 7622Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38724CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL NECK DISSECTION)60.66672.0352.6733NANA 7623Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Room & Board Semiprivate (Two Beds)-Detoxification6124.3162.9415NANA 7624Carrier O2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45330SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)60.833316.7528.0415NANA 7625Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22853Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)12124.3149.63111NANA 7626Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22633Filter, disposable, used with positive airway pressure device9124.316818NANA 7627Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63052LAMINECTOMY, 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; SINGLE VERTEBRAL SEGMENT7124.3157.6516NANA 7628Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22840Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)7139.237NANA 7629Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63048Room & Board Semiprivate (Two Beds)-Psychiatric6124.363.2515NANA 7630Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22614Room & Board Semiprivate (Two Beds)-Detoxification6124.3162.9415NANA 7631Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61783STEREOTACTIC COMPUTER-ASSISTED (NAVIGATIONAL) PROCEDURE; SPINAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)4124.3146.6413NANA 7632Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63047Room & Board Private (One Bed)-Psychiatric4168.274NANA 7633Carrier O2024Inpatient 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)4124.3146.9913NANA 7634Carrier O2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE;411.8717.9213NANA 7635Carrier O2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT32100THORACOTOMY, MAJOR; WITH EXPLORATION AND BIOPSY1191.711NANA 7636Carrier O2024Outpatient 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 total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.5340.6761.378.7154480NANA 7637Carrier O2024Outpatient Med-SurgCodes with the highest total number of 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 total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.5060.69171.48.5753453NANA 7638Carrier O2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.5060.69761.438.7550456NANA 7639Carrier O2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99205Office 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 total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.5010.68861.418.6352449NANA 7640Carrier O2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204Office or other outpatient visit for the evaluation and management of a new 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, 45 minutes must be met or exceeded.5010.69261.438.8150451NANA 7641Carrier O2024Outpatient 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 total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.4990.69941.418.8951448NANA 7642Carrier O2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.4970.69421.478.9352445NANA 7643Carrier O2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99212Office 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 total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.4910.69451.568.7551440NANA 7644Carrier O2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99211Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional4900.69591.459.0249441NANA 7645Carrier O2024Outpatient 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)3990.93987.9625.748351NANA 7646Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78815Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh3310.862.891815NANA 7647Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78816Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body3310.892.811716NANA 7648Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78813POSITRON EMISSION TOMOGRAPHY (PET) IMAGING; WHOLE BODY3210.892.891715NANA 7649Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78812POSITRON EMISSION TOMOGRAPHY (PET) IMAGING; SKULL BASE TO MID-THIGH3210.892.891715NANA 7650Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78811POSITRON EMISSION TOMOGRAPHY (PET) IMAGING; LIMITED AREA (EG, CHEST, HEAD/NECK)3210.892.891715NANA 7651Carrier O2024Outpatient 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 performed2910.942.65326NANA 7652Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77065DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL2510.842.25421NANA 7653Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70460COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S)2511.433.05520NANA 7654Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70470COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS2511.433.05520NANA 7655Carrier O2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL2511.433.04520NANA 7656Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft40.16145.624NANA 7657Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97530Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes20.0065128.132NANA 7658Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility20.0059128.132NANA 7659Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73720Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences20.008102.662NANA 7660Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73722MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)20.008102.662NANA 7661Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT62323Injection(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, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)20.064581.422NANA 7662Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97116THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING)20.0093128.132NANA 7663Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64483INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; LUMBAR OR SACRAL, SINGLE LEVEL20.034571.962NANA 7664Carrier O2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73719MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITH CONTRAST MATERIAL(S)20.008102.662NANA 7665Carrier O2024Outpatient 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 level20.095252.952NANA 7666Carrier O2024Inpatient 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 diem10172.8110NANA 7667Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room & Board in a psychiatric setting (semi-private/two-bed). Used for inpatient psychiatric services8116.68NANA 7668Carrier O2024Inpatient 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)60.166719.8324.6915NANA 7669Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0010ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)5119.445NANA 7670Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED50.837.795NANA 7671Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Semi-private, two-bed room for detoxification services in a hospital setting.40.522.8511.2213NANA 7672Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue114Private room & board for psychiatric services.4118.094NANA 7673Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9485CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM1117.81NANA 7674Carrier O2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2013PSYCHIATRIC HEALTH FACILITY SERVICE, PER DIEM113.441NANA 7675Carrier O2024Inpatient 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 diem10172.8110NANA 7676Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room & Board in a psychiatric setting (semi-private/two-bed). Used for inpatient psychiatric services8116.68NANA 7677Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0010ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)5119.445NANA 7678Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue114Private room & board for psychiatric services.4118.094NANA 7679Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9485CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM1117.81NANA 7680Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2013PSYCHIATRIC HEALTH FACILITY SERVICE, PER DIEM113.441NANA 7681Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99221INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED40.841.144NANA 7682Carrier O2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Semi-private, two-bed room for detoxification services in a hospital setting.20.515.922NANA 7683Carrier O2024Inpatient 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)10.166742.221NANA 7684Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY, 60 MINUTES WITH PATIENT490.28578.21107.26940NANA 7685Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM250.486.1344.39322NANA 7686Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION170.29411.77.12215NANA 7687Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY, 45 MINUTES WITH PATIENT130.38461.368.82211NANA 7688Carrier O2024Outpatient 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 management110.45452.9572.76110NANA 7689Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT; DELIVERY AND MANAGEMENT, PER SESSION110.45452.9572.76110NANA 7690Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT; PLANNING110.45452.9572.75110NANA 7691Carrier O2024Outpatient MH-SUDCodes 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 total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.100.21.610NANA 7692Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90832PSYCHOTHERAPY, 30 MINUTES WITH PATIENT70.28572.4315.316NANA 7693Carrier O2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204Office or other outpatient visit for the evaluation and management of a new 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, 45 minutes must be met or exceeded.60.66673.16NANA 7694Carrier O2024Outpatient 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 total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.212.612NANA 7695Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99203Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.210.562NANA 7696Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99441Telephone 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; 5-10 minutes of medical discussion110.431NANA 7697Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96127Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument114.771NANA 7698Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96165HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PATIENTS), FACE-TO-FACE; EACH ADDITIONAL 151169.521NANA 7699Carrier O2024Outpatient 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 discussion110.431NANA 7700Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99211Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional110.461NANA 7701Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99212Office 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 total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.110.461NANA 7702Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96164HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PATIENTS), FACE-TO-FACE; INITIAL 30 MINUTES1169.511NANA 7703Carrier O2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204Office or other outpatient visit for the evaluation and management of a new 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, 45 minutes must be met or exceeded.40.66670.584NANA 7704Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE1760.965923.035817.527169NANA 7705Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE1070.962644.454355.19899NANA 7706Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)190.894739.551284.95316NANA 7707Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4222INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)15115.57960.71114NANA 7708Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7038FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE1412.01432.79113NANA 7709Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0781Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient13115.571033.4112NANA 7710Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7035HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE1312.12415.51112NANA 7711Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7034NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HEAD STRAP1212.12294.43111NANA 7712Carrier O2024DMECodes 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-shelf100.730.8310NANA 7713Carrier O2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL3000FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, 'UCB' TYPE, BERKELEY SHELL, EACH100.871.3110NANA 7714Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4222INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)1412.133.29113NANA 7715Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7038FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE14115.5772.53113NANA 7716Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0781Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient13115.5786.12112NANA 7717Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7035HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE1312.1234.63112NANA 7718Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7034NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HEAD STRAP1212.1226.77111NANA 7719Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7037TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE10119.9910NANA 7720Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4604TUBING WITH INTEGRATED HEATING ELEMENT FOR USE WITH POSITIVE AIRWAY PRESSURE DEVICE1012.0825.4719NANA 7721Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1390Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate711.7725.4625NANA 7722Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7036CHINSTRAP USED WITH POSITIVE AIRWAY PRESSURE DEVICE612.1320.7815NANA 7723Carrier O2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7039FILTER, NON DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE612.0817.8315NANA 7724Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2820ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, BELOW KNEE SECTION10.1111193.291NANA 7725Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2750ADDITION TO LOWER EXTREMITY ORTHOSIS, PLATING CHROME OR NICKEL, PER BAR10.5193.291NANA 7726Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4222INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)10.066717.831NANA 7727Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCG0068Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 min1117.831NANA 7728Carrier O2024DMECodes 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 only10.25193.291NANA 7729Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2036Knee-ankle-foot orthosis (KAFO), full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated10.5193.281NANA 7730Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2830ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, ABOVE KNEE SECTION10.5193.291NANA 7731Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2275ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION, PLASTIC MODIFICATION, PADDED/LINED10.125193.291NANA 7732Carrier O2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL2415ADDITION TO KNEE LOCK WITH INTEGRATED RELEASE MECHANISM ( BAIL, CABLE, OR EQUAL), ANY MATERIAL, EACH JOINT10.5193.291NANA 7733Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN190.94741031155.1415NANA 7734Carrier O2024Diabetes 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 supply14149.61699.96311NANA 7735Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service140.8571524.5514NANA 7736Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4221SUPPLIES FOR MAINTENANCE OF NON-INSULIN DRUG INFUSION CATHETER, PER WEEK (LIST DRUGS SEPARATELY)120.916715.57419.13111NANA 7737Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA9277TRANSMITTER; EXTERNAL, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONITORING SYSTEM11132.77620.0529NANA 7738Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK81529.588NANA 7739Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4225SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH71410.967NANA 7740Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103NON-ADJUNCTIVE, NON-IMPLANTED CONTINUOUS GLUCOSE MONITOR OR RECEIVER60.8333179.176NANA 7741Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3CC61352.016NANA 7742Carrier O2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE41222.614NANA 7743Carrier O2024Diabetes 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 supply14116.5463.63311NANA 7744Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9277TRANSMITTER; EXTERNAL, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONITORING SYSTEM11116.3968.8929NANA 7745Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK7161.787NANA 7746Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4225SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH6152.316NANA 7747Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3CC6158.676NANA 7748Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE4155.654NANA 7749Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4238Supply allowance for adjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service2121.342NANA 7750Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2102ADJUNCTIVE, NONIMPLANTED CONTINUOUS GLUCOSE MONITOR (CGM) OR RECEIVER1121.061NANA 7751Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN170.947425.5475.57314NANA 7752Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4221SUPPLIES FOR MAINTENANCE OF NON-INSULIN DRUG INFUSION CATHETER, PER WEEK (LIST DRUGS SEPARATELY)110.916715.5741.81110NANA 7753Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK1197.091NANA 7754Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0784EXTERNAL AMBULATORY INFUSION PUMP, INSULIN1197.091NANA 7755Carrier O2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4225SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH1197.091NANA 7756Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA1460.902.88709677422124DULAGLUTIDENA 7757Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA1430.9400.3246753256677APIXABANNA 7758Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA950.9600.1728395061481EMPAGLIFLOZINNA 7759Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA940.9801.3086419751381EMPAGLIFLOZINNA 7760Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA910.960.4814814810.6406250.2227641ADALIMUMABNA 7761Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA730.6807.2539682541063TIRZEPATIDENA 7762Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA670.5700.387096774562FLASH GLUCOSE SENSORNA 7763Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA570.9300.0666666671245DULAGLUTIDENA 7764Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA540.9400.56450DUPILUMABNA 7765Carrier O2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA520.9400.0243902441141RIVAROXABANNA 7766Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA39100633DEXTROAMPHETAMINE/AMPHETAMINENA 7767Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA28100.063596491919ETANERCEPTNA 7768Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA27100522DEXTROAMPHETAMINE/AMPHETAMINENA 7769Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA23100815DEXTROAMPHETAMINE/AMPHETAMINENA 7770Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA21100417DEXTROAMPHETAMINE/AMPHETAMINENA 7771Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA17100512DEXTROAMPHETAMINE/AMPHETAMINENA 7772Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA16100214DAPAGLIFLOZIN PROPANEDIOLNA 7773Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1510078RISANKIZUMAB-RZAANA 7774Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA15100.002777778510OFATUMUMABNA 7775Carrier O2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA15100312METHYLPHENIDATE HCLNA 7776Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMO PROLONG INFUSE W/PUMP7124400160NANA 7777Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHRD CMBN 1NTRSPC LUMBAR300800030NANA 7778Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44626REPAIR BOWEL OPENING210120020NANA 7779Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTS2068BREAST DIEP OR SIEA FLAP210360020NANA 7780Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT55920PLACE NEEDLES PELVIC FOR RT210480020NANA 7781Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT42415EXCISE PAROTID GLAND/LESION2001200020NANA 7782Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT50543LAPARO PARTIAL NEPHRECTOMY11000010NANA 7783Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32667THORACOSCOPY W/W RESECT ADDL110720010NANA 7784Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT48999UNLISTED PROCEDURE PANCREAS110240010NANA 7785Carrier N2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22800ARTHRD PST DFRM<6 VRT SGM110960010NANA 7786Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMO PROLONG INFUSE W/PUMP7124400160NANA 7787Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44626REPAIR BOWEL OPENING210120020NANA 7788Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS2068BREAST DIEP OR SIEA FLAP210360020NANA 7789Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55920PLACE NEEDLES PELVIC FOR RT210480020NANA 7790Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50543LAPARO PARTIAL NEPHRECTOMY11000010NANA 7791Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32667THORACOSCOPY W/W RESECT ADDL110720010NANA 7792Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT48999UNLISTED PROCEDURE PANCREAS110240010NANA 7793Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22800ARTHRD PST DFRM<6 VRT SGM110960010NANA 7794Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32608THORACOSCOPY W/BX NODULE110240010NANA 7795Carrier N2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125REMOVAL OF PENIS110480010NANA 7796Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM350.886080.900350NANA 7797Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA290.8972426.803260NANA 7798Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN220.7271212602200NANA 7799Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE180.889242402160NANA 7800Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ7323EUFLEXXA INJ PER DOSE15108.601140NANA 7801Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM130.846081.200130NANA 7802Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99213OFFICE O/P EST LOW 20 MIN130.692017401120NANA 7803Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA100.9144130.70190NANA 7804Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22853INSJ BIOMECHANICAL DEVICE100.6074.400100NANA 7805Carrier N2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22845INSERT SPINE FIXATION DEVICE90.7780800090NANA 7806Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95810POLYSOM 6/> YRS 4/> PARAM310.886035.600310NANA 7807Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0585INJECTION,ONABOTULINUMTOXINA260.8972426.103230NANA 7808Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE O/P EST MOD 30 MIN160.7271287.402140NANA 7809Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64615CHEMODENERV MUSC MIGRAINE160.8892422.302140NANA 7810Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ7323EUFLEXXA INJ PER DOSE15108.601140NANA 7811Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95811POLYSOM 6/>YRS CPAP 4/> PARM110.846063.300110NANA 7812Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99213OFFICE O/P EST LOW 20 MIN90.69201080180NANA 7813Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ0178AFLIBERCEPT INJECTION910240270NANA 7814Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTQ5103INJECTION, INFLECTRA90.91441110180NANA 7815Carrier N2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9306INJECTION, PERTUZUMAB, 1 MG81068.60170NANA 7816Carrier N2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ0585Injection, Botox51027840050NANA 7817Carrier N2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99214Established patient office or other outpatient visit, 30-39 minutes110720010NANA 7818Carrier N2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93655Intracardiac Electrophysiological Procedures/Studies110480010NANA 7819Carrier N2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33249Pacemaker or Implantable Defibrillator Procedure1102880010NANA 7820Carrier N2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ0741Injection, Cabenuva11000010NANA 7821Carrier N2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ1437Injection, Monoferric110240010NANA 7822Carrier N2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002SUBSTANCE ABUSE RESIDENTIAL2100200NANA 7823Carrier N2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126DETOX1100100NANA 7824Carrier N2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001EATING DISORDER RESIDENTIAL1100100NANA 7825Carrier N2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002SUBSTANCE ABUSE RESIDENTIAL2100200NANA 7826Carrier N2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126DETOX1100100NANA 7827Carrier N2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001EATING DISORDER RESIDENTIAL1100100NANA 7828Carrier N2024Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue1001Eating Disorder Residential112400100NANA 7829Carrier N2024Inpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealRevenue1002Substance Abuse Residential114800100NANA 7830Carrier N2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION (TMS)3100030NANA 7831Carrier N2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT0362TAPPLIED BEHAVIORAL ANALYSIS1100010NANA 7832Carrier N2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION1100010NANA 7833Carrier N2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90867TRANSCRANIAL MAGNETIC STIMULATION (TMS)3100030NANA 7834Carrier N2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT0362TAPPLIED BEHAVIORAL ANALYSIS1100010NANA 7835Carrier N2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION1100010NANA 7836Carrier N2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11000010NANA 7837Carrier N2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE110240010NANA 7838Carrier N2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR110240010NANA 7839Carrier N2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL8688IMPLT NROSTM PLS GEN DUA NON11000010NANA 7840Carrier N2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0466HOME VENT NON-INVASIVE INTER110480010NANA 7841Carrier N2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL1846KO W ADJ FLEX/EXT ROTAT MOLD11000010NANA 7842Carrier N2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8680IMPLT NEUROSTIM ELCTR EACH11000010NANA 7843Carrier N2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8614COCHLEAR DEVICE110240010NANA 7844Carrier N2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0760OSTEOGEN ULTRASOUND STIMLTOR110240010NANA 7845Carrier N2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL8688IMPLT NROSTM PLS GEN DUA NON11000010NANA 7846Carrier N2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0466HOME VENT NON-INVASIVE INTER110480010NANA 7847Carrier N2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1846KO W ADJ FLEX/EXT ROTAT MOLD11000010NANA 7848Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADEXCOM G7 SENSOR820.53663.97017650NANA 7849Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADEXCOM G6 SENSOR340.88240.56.507270NANA 7850Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 3 SENSOR340.382418.51606280NANA 7851Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADEXCOM G7 RECEIVER220.36369.37.103190NANA 7852Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADEXCOM G6 TRANSMITTER210.76190.13.504170NANA 7853Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 3 PLUS SENSOR100.31.627.30460NANA 7854Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 2 SENSOR90.222261.110.70180NANA 7855Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 14 DAY SENSOR50519.30140NANA 7856Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANATRUE METRIX GLUCOSE TEST STRIP30.33330.10.40210NANA 7857Carrier N2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 3 READER30.333300.60120NANA 7858Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANACONTOUR NEXT TEST STRIP210470110NANA 7859Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 2 READER1161.11.70010NANA 7860Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAFREESTYLE TEST STRIPS11000100NANA 7861Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAACCU-CHEK GUIDE TEST STRIP1100.20010NANA 7862Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADEXCOM G6 SENSOR340.88240.56.507270NANA 7863Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADEXCOM G6 TRANSMITTER210.76190.13.504170NANA 7864Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADEXCOM G7 SENSOR440.53663.97017650NANA 7865Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 3 SENSOR340.382418.51606280NANA 7866Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADEXCOM G7 RECEIVER820.36369.37.103190NANA 7867Carrier N2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANAFREESTYLE LIBRE 3 READER30.333300.60120NANA 7868Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA1950.53853.970271680semaglutideOZEMPIC .25 OR 0.5 PEN INJCTR 7869Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA1610.78260.16.20211400tirzepatideZEPBOUND 2.5 MG/0.5 PEN INJCTR 7870Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA1460.45210.86.90261200tirzepatideMOUNJARO 2.5 MG/0.5 PEN INJCTR 7871Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA940.77662.23.908860semaglutideWEGOVY 0.25MG/0.5 PEN INJCTR 7872Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA820.536606.2017650DexcomDEXCOM G7 SENSOR EACH 7873Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA690.83820.28.5018510semaglutideOZEMPIC 1/0.75 (3) PEN INJCTR 7874Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA680.695702.908600rimegepantNURTEC ODT 75 MG TAB RAPDIS 7875Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA530.84910.78.8027260apixabanELIQUIS 5 MG TABLET 7876Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA490.85712.7308410dupillamabDUPIXENT PEN 300 MG/2ML PEN INJCTR 7877Carrier N2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA490.69391.93.902470ruxolitinibOPZELURA 1.5 % CREAM (G) 7878Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA3410.17.804300dextroamphetamineDEXTROAMPHETAMINE-AMPH 20 MG CAP.SR 24H 7879Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA28110.9015130rivaroxabanXARELTO 20 MG TABLET 7880Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA22113.7005170dextroamphetamineDEXTROAMPHETAMINE-AMPH 10 MG TABLET 7881Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA2013.60.105150dextroamphetamineDEXTROAMPHETAMINE-AMPHET ER 20 MG CAP.SR 24H 7882Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA16102.604120upadacitinibRINVOQ 15 MG TAB ER 24H 7883Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA16100.105110dextroamphetamineDEXTROAMPHETAMINE-AMPHET ER 10 MG CAP.SR 24H 7884Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1415.33.30590methylphenidateMETHYLPHENIDATE HCL 10 MG TABLET 7885Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1310003100methylphenidateMETHYLPHENIDATE ER 36 MG TAB ER 24 7886Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA13100.10490atogepantQULIPTA 60 MG TABLET 7887Carrier N2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA13117.25.403100etanerceptENBREL SURECLICK 50MG/ML(1) PEN INJCTR 7888Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA5107680050EvolocumabREPATHA 7889Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA2102160020FremanezumabAJOVY 7890Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA210480020DupilumabDUPIXENT 7891Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA2109840020SemaglutideOZEMPIC 7892Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA2107440020SemaglutideWEGOVY 7893Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA2103840020TirzepatideZEPBOUND 7894Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1101680010EerenumabAIMOVIG 7895Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1104320010EerenumabAIMOVIG AUTOINJECTOR 7896Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA110480010Bupropion HydrochlorideAPLENZIN 7897Carrier N2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA1101920010Dextromethorphan/BupropionAUVELITY 7898Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV4310.510430NANA 7899Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV3510.812.51340NANA 7900Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST141142120NANA 7901Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP131328.921120NANA 7902Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU80.751263.67260NANA 7903Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT120.101REF SKILLED NURSING FACILITY (SNF)60.2587853510NANA 7904Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH6142.67060NANA 7905Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447TOTAL KNEE ARTHROPLASTY6059060NANA 7906Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95720EEG, CONT RECORD, EA INCRMNT >12 HRS, UP TO 26 HRS, INTERP & REP AFTER EA 24 HR; W/VIDEO510.12050NANA 7907Carrier C2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTG4033SKILLED NURSING FACILITY SS50.2459320NANA 7908Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV4310.510430NANA 7909Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV3510.812.51340NANA 7910Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST141142120NANA 7911Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP131328.921120NANA 7912Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH6142.67060NANA 7913Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95720EEG, CONT RECORD, EA INCRMNT >12 HRS, UP TO 26 HRS, INTERP & REP AFTER EA 24 HR; W/VIDEO510.12050NANA 7914Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61624TRANSCATH OCCLUSION/EMBOLIZAT PERCUT CNS511632140NANA 7915Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT36430TRANSFUSION BLOOD/BLOOD COMPONENTS5124.4050NANA 7916Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50360TRANSPLANTATION OF KIDNEY5130.6050NANA 7917Carrier C2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59409VAG DELIVERY ONLY (W/WO EPISIOTOMY &/OR FORCEPS)410.56040NANA 7918Carrier C2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61512CRANIECT TREPH BONE FLAP CRANIO EXC MENINGIO SUPR30.666748.67030NANA 7919Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN576160.98534.957.054832527840NANA 7920Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES96850.99223.445.9132693590NANA 7921Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE70600.99181.542.5113969210NANA 7922Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT33050.99731.345.59132140NANA 7923Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER16160.99631.7810.0217614400NANA 7924Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERA ACTVI DIRECT PAT CONTACT EA 15 MIN15410.9892.598.957214690NANA 7925Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES14820.9733.8814.4717613060NANA 7926Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,13650.83597.7532.8419711680NANA 7927Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99201.555REF MISCELLANEOUS EXTERNAL13060.938715.428.9414211640NANA 7928Carrier C2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JOINT11850.80344.7326.879710880NANA 7929Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY99610.574.63476490NANA 7930Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95806SLEEP STUDY, UNATTENDED35311.685.9423510NANA 7931Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93015ETT STRESS &/OR PHARMACOLOGICAL STRESS34411.725.79183260NANA 7932Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45389COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC STENT PLACEMENT30411.155.84132910NANA 7933Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000CYSTOURETHROSCOPY (SEP PROC)23512.5830.81122230NANA 7934Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17000DESTRUCT 1ST AK PREMALIG LESION22811.332.562220NANA 7935Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93922NON-INVASIVE STUDY EXTREMITY ARTERY BILAT SINGLE20410.286.51111930NANA 7936Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99024POST OP FOLLOW-UP VISIT GLOBAL19713.7520.97281690NANA 7937Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93970DUPLEX SCAN, VEINS, BILATERAL17810.868.13141640NANA 7938Carrier C2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99201.144REF PODIATRY - INTERNAL177139.81147.77211560NANA 7939Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0169UNUDT15 & TPMT GENE ANALYSIS COMMON VARIANTS20.528.5020NANA 7940Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36474VENOUS ABLATION MECHANOCHEMICAL, EA ADDL VEIN20.5175110NANA 7941Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43497TRANSORAL LOWER ESOPHAGEAL MYOTOMY20.540020NANA 7942Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61736LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION20.540.5020NANA 7943Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTS9341HIT ENTERAL GRAV DIEM20.558.5020NANA 7944Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT0479TFRACTIONAL ABL LASER FENESTRATION; FIRST 100 SQCM30.33331648120NANA 7945Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64555PERCUT IMPLANT NEUROSTIM ELECTRO30.333357030NANA 7946Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81170ABL1,GENE ANALYSIS, VARIANTS IN THE KINASE DOMAIN30.33332645.5120NANA 7947Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81201APC GENE ANALYSIS FULL GENE SEQUENCE30.333340.67030NANA 7948Carrier C2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81324PMP22 GENE ANAL DUPLICATION/DELETION ANALYSIS30.333340.67030NANA 7949Carrier C2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT128.102REF IP CD RESIDENTIAL TREATMENT CENTER3115300NANA 7950Carrier C2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH2020THER BEHAV SVC, PER DIEM1170100NANA 7951Carrier C2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT128.102REF IP CD RESIDENTIAL TREATMENT CENTER3115300NANA 7952Carrier C2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2020THER BEHAV SVC, PER DIEM1170100NANA 7953Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT85440.99630.922.7230682380NANA 7954Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS32190.99840.554.1319130280NANA 7955Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES6780.96026.9211.29276510NANA 7956Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY4940.9965.47.2954890NANA 7957Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR3200.971920.58.3823180NANA 7958Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT2350.83833556.6222330NANA 7959Carrier C2024Outpatient 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 MINS1850.85417299.0311840NANA 7960Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR1720.872118.540.5221700NANA 7961Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES1350.977819.239.0751300NANA 7962Carrier C2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES10212.5701020NANA 7963Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES10212.5701020NANA 7964Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS8811.27.165830NANA 7965Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90806.102REF MENTAL HEALTH EXTERNAL46126.980460NANA 7966Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTS9480PSYCH SVC INTENSIVE OUTPT19112.950190NANA 7967Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96156HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT712.14070NANA 7968Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR617060NANA 7969Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90849MULT-FAMILY GROUP PSYCHOTHERAPY412.5040NANA 7970Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE4133952.33130NANA 7971Carrier C2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214.103REF SUBSTANCE USE DISORDER TREATMENT - EXTERNAL311.33030NANA 7972Carrier C2024Outpatient 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 MINS2160.5020NANA 7973Carrier C2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT2350.01283556.6222330NANA 7974Carrier C2024Outpatient 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 MINS1850.00547299.0311840NANA 7975Carrier C2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY 60 MIN PATIENT85440.00010.922.7230682380NANA 7976Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE21360.9930.725.3152816080NANA 7977Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE13060.99851.688.957525540NANA 7978Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL7190.99720.325.695251940NANA 7979Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT5370.99812.677.652612760NANA 7980Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR5110.9981.882244870NANA 7981Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT49313.83.7954880NANA 7982Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA4900.9981.113.83574330NANA 7983Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP307123.7182990NANA 7984Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0118CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH3010.98672.4910.631341670NANA 7985Carrier C2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE1390OXYGEN CONCENTRATOR2880.98611.84.89971910NANA 7986Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT49313.83.7954880NANA 7987Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP307123.7182990NANA 7988Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA26110.53.4162550NANA 7989Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTDME0003DME ELECTRIC BREAST PUMP KIT PURCHASE (E0603)260114.7118.75209510NANA 7990Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW26010.53.422580NANA 7991Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND20911.3102090NANA 7992Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4670AUTOMATIC BP MONITOR DIAL18410.562.79391450NANA 7993Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4388DRAINABLE PCH W EX WEAR BARR17310.695.4477960NANA 7994Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1852KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH/CALF, PREFAB, OFF-THE-SHELF15310.878.54231300NANA 7995Carrier C2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0156SEAT ATTACHMENT, WALKER12012.242.3369510NANA 7996Carrier C2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5020PARTIAL FOOT MOLDED SOCKET20.544020NANA 7997Carrier C2024DMECodes 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, EA150.0667164.071140NANA 7998Carrier C2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTB4149ENTERAL FORMULA, MANUFACT, ADM VIA ENTERAL FEED TUBE, 100 CALORIES=1UN170.05882548.82150NANA 7999Carrier C2024DMECodes 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 UN250.0439.840250NANA 8000Carrier C2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL1960AFO POS SOLID ANK PLASTIC MO280.03570.0720.931270NANA 8001Carrier C2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0760OSTEOGEN U/S STIMLTOR630.03179.1948.4716470NANA 8002Carrier C2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL3010FOOT INSERT REMOVABLE LONG ARCH SPPT1550.0129110.8811540NANA 8003Carrier C2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL3030FOOT INSERT REMOVABLE FORMED TO PT860.011612.650860NANA 8004Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER15520.78992.4822.119914530NANA 8005Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN9520.98951.986.39519010NANA 8006Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS3040.96052.2617.66572470NANA 8007Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH2740.98544.9917.72522220NANA 8008Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN2630.99622.15.07102530NANA 8009Carrier C2024Diabetes 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 SHOE1650.99391.3313.6231620NANA 8010Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP1300.92314.524.6261240NANA 8011Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE2102ADJUNCTIVE NONIMPLANTED CGM/RECEIVER800.67510.530.732780NANA 8012Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG710.98595.8923.039620NANA 8013Carrier C2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV601215.532580NANA 8014Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV601215.532580NANA 8015Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5501DIABETIC CUSTOM MOLDED SHOE581113.934540NANA 8016Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG4012.3318.783370NANA 8017Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK2510.414.055200NANA 8018Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92012INTERMEDIATE EYE EXAM ESTABLISHED PATIENT2118.240210NANA 8019Carrier C2024Diabetes 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 EA19111.370190NANA 8020Carrier C2024Diabetes 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 GL18111.170180NANA 8021Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA9274EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA1810.07122160NANA 8022Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67028GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL151233.141140NANA 8023Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99201.555REF MISCELLANEOUS EXTERNAL14128.790140NANA 8024Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTDME0063REF DME CONTINUOUS GLUCOSE MONITOR AND SUPPLIES530.01891432.421520NANA 8025Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2102ADJUNCTIVE NONIMPLANTED CGM/RECEIVER800.012510.530.732780NANA 8026Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH2740.00364.9917.72522220NANA 8027Carrier C2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER15520.00132.4822.119914530NANA 8028Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA33700.42460.1957.99683302semaglutideOzempic, Rybelsus 8029Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA13050.41990.3955.61531252lisdexamfetamineVyvanse 8030Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA8200.7720.138.63817cyclosporineCequa, Restasis, Verkazia, Vevye 8031Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA8130.60640.3344.3325788budesonide-formoterolSymbicort, Breyna 8032Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7930.50320.5157.3624769liraglutideVictoza 8033Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7360.86280.3518.91105631rivaroxabanXarelto 8034Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6550.58021.242.88109546apixabanEliquis 8035Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6540.07650.2979.4217637tirzepatideMounjaro 8036Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5870.08350.0881.624583semaglutideWegovy 8037Carrier C2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5530.93120.7631.8125528adalimumab-attoAmjevita 8038Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA20107416lenalidomideRevlimid 8039Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA181022315lenvatinibLenvima 8040Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA181051315tocilizumabTyenne 8041Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA171222215eltrombopagAlvaiz 8042Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA161026214osimertinibTagrisso 8043Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA121128111vedolizumabEntyvio 8044Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1110229dofetilideTikosyn 8045Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA111029110lasmiditanReyvow 8046Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10142237pomalidomidePomalyst 8047Carrier C2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7102816voriconazoleVfend 8048Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA11121.251belzutifanWelireg 8049Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.562.22clobazamSympazan 8050Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.563.862interferon-beta 1aAvonex 8051Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.526.272fenfluramineFintepla 8052Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.482.995cenegerminOxervate 8053Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.43.2258.7214esketamineSpravato 8054Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA80.3750.2938.2417mavacamtenCamzyos 8055Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA80.3750.1854.926nintedanibOfev 8056Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.333337.713cabozantinibCabometyx 8057Carrier C2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.333322.2917.7721ponatinibIclusig 8058Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP2218.7129.737150NANA 8059Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV19150190NANA 8060Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1411.140140NANA 8061Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST812080NANA 8062Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU60.666734.33060NANA 8063Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y60.83338108.6150NANA 8064Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,50.239.8050NANA 8065Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT61624TRANSCATH OCCLUSION/EMBOLIZAT PERCUT CNS415.25040NANA 8066Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22633ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR30.3333484120NANA 8067Carrier D2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44620CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE311030NANA 8068Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96416CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP2218.7129.737150NANA 8069Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59510FULL ROUT OBSTE CARE,CESAREAN DELIV19150190NANA 8070Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT59400FULL ROUT OBSTE CARE,VAGINAL DELIV1411.140140NANA 8071Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204COLECTOMY LAP PARTIAL W/ ANAST812080NANA 8072Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61624TRANSCATH OCCLUSION/EMBOLIZAT PERCUT CNS415.25040NANA 8073Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44620CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE311030NANA 8074Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45378COLONOSCOPY DX W/WO SPEC/COLON DECOMP (SEP PROC)3117.33030NANA 8075Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61510CRANIECT TREPH BONE FLAP CRANIO EXC TUMOR SUPRA310.135.5120NANA 8076Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT51590CYSTECTOMY W/ URETEROILEAL CONDUIT/SIGMOID BLADR3122.33030NANA 8077Carrier D2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78264GASTRIC EMPTYING STUDY312.67030NANA 8078Carrier D2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130TOTAL HIP ARTHROPLASTY20.523.5020NANA 8079Carrier D2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22558ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU60.166734.33060NANA 8080Carrier D2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43644LAP GASTRIC BYPASS/ROUX-EN-Y60.16678108.6150NANA 8081Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN204450.9923.15.091386190590NANA 8082Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97110THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES32610.99572.554.469231690NANA 8083Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97124THERA PROC 1+ AREAS EA 15 MIN MASSAGE16860.99580.553.272216640NANA 8084Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI ANY JOINT11200.74118.8933.961519690NANA 8085Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN W/ & W/O CONTRAST,9180.73869.2536.771078110NANA 8086Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380COLONOSCOPY W/ BX SINGLE/MULT9130.9881.675.24488650NANA 8087Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER76212.59.55806820NANA 8088Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72158MRI LUMBAR W/WO CONTRST SPINE6120.424812.0632.3535590NANA 8089Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MAGNETIC RESONANCE (EG, PROTON) LUMBAR5510.402911.3940.68714800NANA 8090Carrier D2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99202OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES5160.9942312.4354810NANA 8091Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93306TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER76212.59.55806820NANA 8092Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77080DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE29810.62.25152830NANA 8093Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT96040GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY28210.723.81822000NANA 8094Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES279111.679.33362430NANA 8095Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99201.114REF GASTROENTEROLOGY - INTERNAL263122.1152.5392540NANA 8096Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95806SLEEP STUDY, UNATTENDED201117.2212000NANA 8097Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT98941CHIROPRACTIC MANIP TX (CMT) SPINAL 3-4 REGIONS16513.8901650NANA 8098Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11102TANGENTIAL BIOPSY OF SKIN; FIRST LESION16310.652.2911620NANA 8099Carrier D2024Outpatient 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 BLCK16010.753.06161440NANA 8100Carrier D2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97810ACUPUNCTURE, 1ST 15 MIN, W/O ELECT STIM15610.023.6111550NANA 8101Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21743RECON REP PECTUS EXCAVATM/CARINATM; W/THORACSCPY11148010NANA 8102Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT37761SUBFASCIAL LIGATION PERFORATOR VEIN, OPEN, 1 LEG20.556.5020NANA 8103Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT42145PALATOPHARYNGOPLASTY20.574020NANA 8104Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81425GENOME SEQUENCE ANALYSIS20.596020NANA 8105Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTA9513LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MCI20.537020NANA 8106Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ9225HISTRELIN IMPLANT20.521.11020NANA 8107Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL8693AUDITORY OSSEOINTEGRATED DEVICE ABUTMENT, ANY LENGTH, REPLACEMENT ONLY20.531.5020NANA 8108Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33285INSERT SUBCUTANEOUS CARDIAC RHYTHM MONITOR, INCL PROGRAM60.333341.5060NANA 8109Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81404MOLECULAR PATHOLOGY PROCEDURE LEVEL 540.2566.75040NANA 8110Carrier D2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTJ3241INJ, TEPROTUMUMAB-TRBW, 10 MG40.2517.53040NANA 8111Carrier D2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH0045RESPITE NOT-IN-HOME PER DIEM10144010NANA 8112Carrier D2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPTH2020THER BEHAV SVC, PER DIEM114100NANA 8113Carrier D2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0045RESPITE NOT-IN-HOME PER DIEM10144010NANA 8114Carrier D2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH2020THER BEHAV SVC, PER DIEM114100NANA 8115Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY 60 MIN PATIENT7000.99571.12.22736270NANA 8116Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS38110.431.65563250NANA 8117Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES2510.97216.215.24102410NANA 8118Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR940.904330.020940NANA 8119Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT930.82831.560.962910NANA 8120Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96130PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; FIRST HOUR650.98467.820650NANA 8121Carrier D2024Outpatient 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 MINS640.7656101.880640NANA 8122Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES310.967715.4635.125260NANA 8123Carrier D2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY2812.290280NANA 8124Carrier D2024Outpatient 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 MINS230.8696109.450230NANA 8125Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90836PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS38110.431.65563250NANA 8126Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90853GROUP PSYCHOTHERAPY2812.290280NANA 8127Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN151421.431140NANA 8128Carrier D2024Outpatient 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 MINS12110.080120NANA 8129Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97155ADAPTIVE BEHAV TX W/PROTOCOL MOD, ADM BY PHYS OR QUAL PROF, EA 15 MINS3183030NANA 8130Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTH0020ALCOHOL AND/OR DRUG SERVICES311030NANA 8131Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834PSYCHOTHERAPY 45 MIN PATIENT2118020NANA 8132Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90870ECT (W/ MONITORING) SINGLE SEIZURE2147138110NANA 8133Carrier D2024Outpatient 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 HOUR2126020NANA 8134Carrier D2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90833PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS210020NANA 8135Carrier D2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90792PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES310.032315.4635.125260NANA 8136Carrier D2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90868TRANSCRANIAL MAG STIMJ TX DLVR & MGMT930.021531.560.962910NANA 8137Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0601CPAP DEVICE9120.99120.849.981597530NANA 8138Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT30310.182.4913020NANA 8139Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR29710.761.9822950NANA 8140Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE28812.2811.33255330NANA 8141Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA24417.454.56112330NANA 8142Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3908WRIST SPLINT W/WO COCK-UP1900.99472.193.0831870NANA 8143Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0604DME ELECTRIC BREAST PUMP KIT RENTAL1830.99450.368.13137460NANA 8144Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT1800.98893.99.26601200NANA 8145Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA15412.332.6931510NANA 8146Carrier D2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND13611.4201360NANA 8147Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL4361PNEUMATIC, WALKING BOOT30310.182.4913020NANA 8148Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0114CRUTCHES METAL UNDERARM PAIR29710.761.9822950NANA 8149Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0603DME ELECTRIC BREAST PUMP KIT PURCHASE28812.2811.33255330NANA 8150Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA7027COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA24417.454.56112330NANA 8151Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3809WRIST THUMB SPICA15412.332.6931510NANA 8152Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3660SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND13611.4201360NANA 8153Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1390OXYGEN CONCENTRATOR11914.299.9249700NANA 8154Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3670SHLDER IMMOB W/ABDUCTION PILLOW11510.573.3621130NANA 8155Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL1902ANKLE LACE UP BRACE9713.740970NANA 8156Carrier D2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE0260HOSPITAL BED, SEMI-ELECTRIC, W/ANY TYPE SIDE RAILS, W/MATTRESS8611.214.366200NANA 8157Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0986MANUAL WHEELCHAIR ACCESS, PUSH-RIM ACTIVATED POWER ASSIST SYS1154010NANA 8158Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2224PROPULSION WHL EXCLUDES TIRE20.533020NANA 8159Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL5700REPLACE SOCKET BEL KNEE PT MODEL40.2583.5040NANA 8160Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTK0005ULTRALIGHTWEIGHT WHEELCHAIR80.12567.39080NANA 8161Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTL8010BREAST PROSTHESIS MASTECTOMY SLEEVE80.1251434.29170NANA 8162Carrier D2024DMECodes 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 TYPE80.125045.25080NANA 8163Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0760OSTEOGEN U/S STIMLTOR270.0372.544.922250NANA 8164Carrier D2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE0601CPAP DEVICE9120.00110.849.981597530NANA 8165Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER4230.7565637.74243990NANA 8166Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN3520.98584.064.19173350NANA 8167Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS1240.94351.1115.9791150NANA 8168Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTA4221WEEKLY SUPPLIES DRUG INFUS CATH990.97984.511.3318810NANA 8169Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN93106.51920NANA 8170Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTE0784EXTERN AMBUL INSULIN INFUS PUMP590.93221126.612570NANA 8171Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV471013.151460NANA 8172Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ0178INJ AFLIBERCEPT (EYLEA) 1 MG460.956535.521.582440NANA 8173Carrier D2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG4112.2516.034370NANA 8174Carrier D2024Diabetes 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 SHOE3710.3211.251360NANA 8175Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97802MED NUTRIT THRPY INIT ASSESS 15 MIN93106.51920NANA 8176Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTG0108DIAB MGMT TRN PER INDIV471013.151460NANA 8177Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTJ9035INJ BEVACIZUMAB 10 MG4112.2516.034370NANA 8178Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE3710.3211.251360NANA 8179Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67228DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN121117.88480NANA 8180Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA5501DIABETIC CUSTOM MOLDED SHOE910.277.13180NANA 8181Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES819.13080NANA 8182Carrier D2024Diabetes 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 DY8113.25080NANA 8183Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4238SPL ALW ADJ NI CGM 1 MONTH SUPPLY = 1 UOS811.112.29170NANA 8184Carrier D2024Diabetes 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 GL617.33060NANA 8185Carrier D2024Diabetes Supplies and EquipCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPTE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER4230.0024637.74243990NANA 8186Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA18040.30430.7754.71231681semaglutideOzempic, Rybelsus 8187Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA9570.34060.8849.3592865lisdexamfetamineVyvanse 8188Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7470.08841.1761.7554693tirzepatideMounjaro 8189Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3780.42861.2347.8841337budesonide-formoterolSymbicort, Breyna 8190Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3070.35180.1759.8516291liraglutideVictoza 8191Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2810.0890.2876.735276semaglutideWegovy 8192Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2540.55910.4144.226248cyclosporineCequa, Restasis, Verkazia, Vevye 8193Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2530.30832.5844.0364189apixabanEliquis 8194Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1950.50781.4863.6223172dupilumabDupixent 8195Carrier D2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1920.75521.3915.7446146adalimumab-attoAmjevita 8196Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12103139cannabidiolEpidiolex 8197Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7103025ribociclibKisqali 8198Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6106806immune globulinHizentra 8199Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6103706grass pollen allergen extract (timothy gras)Grastek 8200Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA6143924enzalutamideXtandi 8201Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA511050posaconzoleNoxafil 8202Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5104505olaparibLynparza 8203Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5101105tiotropiumSpiriva Respimat 8204Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA513914salmeterol xinafoateSerevent 8205Carrier D2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA5112814vedolizumabEntyvio 8206Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA116801cortrophinActhar 8207Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1170.9301ritlecitinib tosylateLitfulo 8208Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.572.3302umeclidiniumIncruse Ellipta 8209Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.410.8227.4332esketamineSpravato 8210Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.3333119.1503albuterolProventil HFA 8211Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA120.252.0686.11111tezepelumab-ekkoTezspire 8212Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.250.0755.8713nintedanibOfev 8213Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.250.489.0922GolimumabSimponi 8214Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.20.5427.9414netarsudil/latanoprostRocklatan 8215Carrier D2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA70.1422.0925valbenazineIngrezza 8216Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL27117.427NANA 8217Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES16116.122.7115NANA 8218Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue762SPECIALTY SERVICES, OBSERVATION HOURS11111.711NANA 8219Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN9134.19NANA 8220Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue158ROOM & BOARD, WARD - REHABILITATION5114.65NANA 8221Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES418.14NANA 8222Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT80053COMPREHENSIVE METABOLIC PANEL3182.73NANA 8223Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71045RADIOLOGIC EXAM CHEST SINGLE VIEW3134.13NANA 8224Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS318.23NANA 8225Carrier E2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue152ROOM & BOARD, WARD - OB31393NANA 8226Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue150ROOM & BOARD, WARD - GENERAL27117.427NANA 8227Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES16116.122.7115NANA 8228Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue762SPECIALTY SERVICES, OBSERVATION HOURS11111.711NANA 8229Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN9134.19NANA 8230Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue158ROOM & BOARD, WARD - REHABILITATION5114.65NANA 8231Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES418.14NANA 8232Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT80053COMPREHENSIVE METABOLIC PANEL3182.73NANA 8233Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71045RADIOLOGIC EXAM CHEST SINGLE VIEW3134.13NANA 8234Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27447ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS318.23NANA 8235Carrier E2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue152ROOM & BOARD, WARD - OB31393NANA 8236Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97161PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS3710.9625.651.828343NANA 8237Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES1760.9893.559.313163NANA 8238Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES1220.9926.562.212110NANA 8239Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST121111.929.618103NANA 8240Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST9018.829.42169NANA 8241Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST85114.123.12560NANA 8242Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN770.76625.3139.6770NANA 8243Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97530THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN770.9749.171.6374NANA 8244Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST6818.2442444NANA 8245Carrier E2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97162PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS620.98420.837.6148.74571NANA 8246Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72148MRI LUMBAR SPINE NO CONTRAST121111.929.618103NANA 8247Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70553MRI BRAIN WO/W CONTRAST9018.829.42169NANA 8248Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI LEFT KNEE NO CONTRAST85114.123.12560NANA 8249Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73721MRI RIGHT KNEE NO CONTRAST6818.2442444NANA 8250Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72141MRI CERVICAL SPINE NO CONTRAST58110.218.81840NANA 8251Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73221MRI RIGHT SHOULDER NO CONTRAST53120.439.2845NANA 8252Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70551MRI BRAIN NO CONTRAST47112.332.31433NANA 8253Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT73221MRI LEFT SHOULDER NO CONTRAST3314.917.3825NANA 8254Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97112THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA2710.547.8324NANA 8255Carrier E2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT27144.727NANA 8256Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64635DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL11321.31NANA 8257Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT23413EXT REFERRAL GYNECOLOGY11143.11NANA 8258Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA9593GALLIUM GA-68 PSMA-11 DIAGNOSTIC UCSF 1 MCI11455.81NANA 8259Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES80.1250.5194.526NANA 8260Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT26660MEMBER REQUEST, PRE-SERVICE220.045719.3335.5418NANA 8261Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT21893REFERRAL OCCUPATIONAL THERAPY PEDIATRICS310.032162.131NANA 8262Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT92507TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND450.0221109243NANA 8263Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT97530THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN770.0139.171.6374NANA 8264Carrier E2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT99203OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES1760.0063.559.313163NANA 8265Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC58117.531.84612NANA 8266Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION51135.948.33318NANA 8267Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP36168.80.2351NANA 8268Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC14123.447.8131NANA 8269Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV2119.72NANA 8270Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue154ROOM & BOARD, WARD - PSYCHIATRIC2143.72NANA 8271Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES11241NANA 8272Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT80321DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2117.11NANA 8273Carrier E2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue914BEHAVIORAL HEALTH TREATMENTS/SVCS, INDIVIDUAL THERAPY11169.71NANA 8274Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC58117.531.84612NANA 8275Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION51135.948.33318NANA 8276Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP36168.80.2351NANA 8277Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1001BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC14123.447.8131NANA 8278Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue194SUBACUTE CARE, LEVEL IV2119.72NANA 8279Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue154ROOM & BOARD, WARD - PSYCHIATRIC2143.72NANA 8280Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES11241NANA 8281Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT80321DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2117.11NANA 8282Carrier E2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue914BEHAVIORAL HEALTH TREATMENTS/SVCS, INDIVIDUAL THERAPY11169.71NANA 8283Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN61150.161NANA 8284Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION570.87791.657NANA 8285Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN38126.738NANA 8286Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN231236.323NANA 8287Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE21151.621NANA 8288Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS19153.727.3181NANA 8289Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90837PSYCHOTHERAPY W/PATIENT 60 MINUTES190.89510219NANA 8290Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIA15169.469.9141NANA 8291Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0410GRP PSYCHOTX NOT MX FAM GP PART HSP/OP 45-50 MIN14145.737113NANA 8292Carrier E2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION111101.9125.3101NANA 8293Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97153ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN61150.161NANA 8294Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97151BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN38126.738NANA 8295Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN231236.323NANA 8296Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue912BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE21151.621NANA 8297Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0001ALCOHOL AND/OR DRUG ASSESS19153.727.3181NANA 8298Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS9480INTENSIVE OUTPATIENT PSYCHIA15169.469.9141NANA 8299Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0410GRP PSYCHOTX NOT MX FAM GP PART HSP/OP 45-50 MIN14145.737113NANA 8300Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION111101.9125.3101NANA 8301Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES91121.19NANA 8302Carrier E2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90792PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES9156.626.481NANA 8303Carrier E2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT90791PSYCHIATRIC DIAGNOSTIC EVALUATION570.01891.657NANA 8304Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0143WALKER FOLDING WHEELED W/O S1570.994242.211.61156NANA 8305Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS1050.98119.7105NANA 8306Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER990.988.599NANA 8307Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP8410.316.4183NANA 8308Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0570NEBULIZER WITH COMPRESSOR760.9872.47.1769NANA 8309Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF62133.162NANA 8310Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR621111.2458NANA 8311Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION55122.255NANA 8312Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE50124.450NANA 8313Carrier E2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2511.320.4124NANA 8314Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0604BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP8410.316.4183NANA 8315Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL1852KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF62133.162NANA 8316Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1390OXYGEN CONCENTRATOR621111.2458NANA 8317Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0730TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION55122.255NANA 8318Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5500DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE50124.450NANA 8319Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0001STANDARD WHEELCHAIR2511.320.4124NANA 8320Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL0457TLSO FLX SC JUNC TERM INF TO SCAP SPINE PREFAB231221.1122NANA 8321Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA9999MISCELLANEOUS DME SUPPLY OR ACCESSORY NOS23136.223NANA 8322Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0202PHOTOTHERAPY LIGHT W/ PHOTOM2212.219.9616NANA 8323Carrier E2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA6212FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA22118.222NANA 8324Carrier E2024Diabetes 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 sensor f1150.70430115NANA 8325Carrier E2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN21127.621NANA 8326Carrier E2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL151103.515NANA 8327Carrier E2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC717.37NANA 8328Carrier E2024Diabetes 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 DRESS2124.72NANA 8329Carrier E2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH113.11NANA 8330Carrier E2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784EXT AMB INFUSN PUMP INSULIN21127.621NANA 8331Carrier E2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230INFUS INSULIN PUMP NON NEEDL151103.515NANA 8332Carrier E2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232SYRINGE W/NEEDLE INSULIN 3CC717.37NANA 8333Carrier E2024Diabetes 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 DRESS2124.72NANA 8334Carrier E2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5120SKIN BARRIER WIPES OR SWABS EACH113.11NANA 8335Carrier E2024Diabetes 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 sensor f1150.70430115NANA 8336Carrier E2024Diabetes 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 subcutaneous sensor f1150.00930115NANA 8337Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2260.752226.0765339202260EMPAGLIFLOZINJARDIANCE 8338Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1930.279833.8095567101930SEMAGLUTIDEOZEMPIC 8339Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA630.507929.248544970630LISDEXAMFETAMINE DIMESYLATEVYVANSE 8340Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA53128.144229560530ADALIMUMAB-ATTOAMJEVITA 8341Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA530.962323.0511740530FREMANEZUMAB-VFRMAJOVY 8342Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA530.924523.555670860530UBROGEPANTUBRELVY 8343Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA350.88579.6101031750350RIVAROXABANXARELTO 8344Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA32125.319479170320SECUKINUMABCOSENTYX 8345Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA280.2540.004206350280LIRAGLUTIDEVICTOZA 8346Carrier E2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA270.777815.120061730270TESTOSTERONE CYPIONATEDEPO-TESTOST 8347Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA53128.144229560530ADALIMUMAB-ATTOAMJEVITA 8348Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA32125.319479170320SECUKINUMABCOSENTYX 8349Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA22152.011578280220SACUBITRIL-VALSARTANENTRESTO 8350Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA20132.346444440200GALCANEZUMAB-GNLMEMGALITY 8351Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA16179.314496530160TICAGRELORBRILINTA 8352Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12130.246805560120CARIPRAZINE HCLVRAYLAR 8353Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10119.768138890100ABATACEPTORENCIA 8354Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10138.079805560100GUSELKUMABTREMFYA 8355Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA8135.66954861080OXYCODONE HCLOXYCONTIN 8356Carrier E2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA7131.79440476070ERENUMAB-AOOEAIMOVIG 8357Carrier E2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1125.06333333010PEGVISOMANTSOMAVERT 8358Carrier E2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.549.05388889020PAROXETINE HCLPAXIL 8359Carrier E2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.53.415555556020MESALAMINEAPRISO, LIALDA, PENTASA 8360Carrier E2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA50.244.0995050CLASCOTERONEWINLEVI 8361Carrier E2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA180.055644.673981480180DUPILUMABDUPIXENT 8362Carrier F2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN2770.4043162579198NANA 8363Carrier F2024Inpatient 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)130.61541952211NANA 8364Carrier F2024Inpatient 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)110.18181613110NANA 8365Carrier F2024Inpatient 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)9018618NANA 8366Carrier F2024Inpatient 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)90.7778102236NANA 8367Carrier F2024Inpatient 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)80.5164517NANA 8368Carrier F2024Inpatient 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)80.625155126NANA 8369Carrier F2024Inpatient 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)70.5714147234NANA 8370Carrier F2024Inpatient 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); lumbar70.42865307NANA 8371Carrier F2024Inpatient 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 flexibility702107NANA 8372Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis61193515NANA 8373Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49320Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)51225514NANA 8374Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT47120Hepatectomy, resection of liver; partial lobectomy41225113NANA 8375Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20680Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)31204212NANA 8376Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63052Laminectomy, 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; single vertebral segment (List separately in addition to code for primary procedure)31194421NANA 8377Carrier F2024Inpatient 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 unilateral3131912NANA 8378Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32674Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure)3131912NANA 8379Carrier F2024Inpatient 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 interpretation315203NANA 8380Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33430Replacement, mitral valve, with cardiopulmonary bypass31221921NANA 8381Carrier F2024Inpatient Med-SurgCodes with the highest percentage of approved 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)31291821NANA 8382Carrier F2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43239Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple4850.952661352433NANA 8383Carrier F2024Outpatient 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)4530.955861450403NANA 8384Carrier F2024Outpatient 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)1600.9259159151NANA 8385Carrier F2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1600.9591511149NANA 8386Carrier F2024Outpatient 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 level1330.9248205113120NANA 8387Carrier F2024Outpatient 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 total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.1240.653223583589NANA 8388Carrier F2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43249Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)1140.947451711103NANA 8389Carrier F2024Outpatient 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 technique1130.938110159104NANA 8390Carrier F2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT731Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified960.93751319888NANA 8391Carrier F2024Outpatient 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)940.82981554391NANA 8392Carrier F2024Outpatient 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)2811537325NANA 8393Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT45390Colonoscopy, flexible; with endoscopic mucosal resection241157123NANA 8394Carrier F2024Outpatient 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 level2311143221NANA 8395Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13152Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm2012921317NANA 8396Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT14060Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less201124119NANA 8397Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76942Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation2012141416NANA 8398Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64479Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level201358119NANA 8399Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT811Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified1811521117NANA 8400Carrier F2024Outpatient 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 cyclophotocoagulation18117018NANA 8401Carrier F2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15260Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less1812825117NANA 8402Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33228Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system112210NANA 8403Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT11621Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm112501NANA 8404Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93312Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report1111601NANA 8405Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT60210Partial thyroid lobectomy, unilateral; with or without isthmusectomy112601NANA 8406Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT74183Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences20.5229611NANA 8407Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT763763D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation20.5229611NANA 8408Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81371HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing)20.55902NANA 8409Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81376HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each20.55902NANA 8410Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81378HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB120.55902NANA 8411Carrier F2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT81379HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C)20.55902NANA 8412Carrier F2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric70121125NANA 8413Carrier F2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification4072122NANA 8414Carrier F2024Inpatient 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 inpatient)311903NANA 8415Carrier F2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation31449812NANA 8416Carrier F2024Inpatient 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 diem30.33333303NANA 8417Carrier F2024Inpatient 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)10201NANA 8418Carrier F2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation10610NANA 8419Carrier F2024Inpatient 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 minutes101101NANA 8420Carrier F2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT77412Radiation treatment delivery, => 1 MeV; complex101410NANA 8421Carrier F2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250Computed tomography, thorax, diagnostic; without contrast material101201NANA 8422Carrier F2024Inpatient 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 inpatient)311903NANA 8423Carrier F2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation3143.9166669812NANA 8424Carrier F2024Inpatient 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 diem30.33333303NANA 8425Carrier F2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric7011.6749991125NANA 8426Carrier F2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification407.1249992122NANA 8427Carrier F2024Inpatient 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)10201NANA 8428Carrier F2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation106.08333310NANA 8429Carrier F2024Inpatient 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 minutes101101NANA 8430Carrier F2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77412Radiation treatment delivery, => 1 MeV; complex1013.68333310NANA 8431Carrier F2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT71250Computed tomography, thorax, diagnostic; without contrast material101201NANA 8432Carrier F2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem970.69079611780NANA 8433Carrier F2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours740.85141550668NANA 8434Carrier F2024Outpatient 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 session650.876927891748NANA 8435Carrier F2024Outpatient 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 management500.882493842NANA 8436Carrier F2024Outpatient 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 management500.9226921040NANA 8437Carrier F2024Outpatient 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 education410.853758041NANA 8438Carrier F2024Outpatient 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 plan360.91672288234NANA 8439Carrier F2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation330.72733177825NANA 8440Carrier F2024Outpatient 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 minutes300.93332588228NANA 8441Carrier F2024Outpatient 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 minutes270.92592483324NANA 8442Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0032Mental health service plan development by nonphysician1412579212NANA 8443Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97152Behavior 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 minutes518805NANA 8444Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2019Therapeutic behavioral services, per 15 minutes5111005NANA 8445Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97157Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guardians/caregivers, each 15 minutes216502NANA 8446Carrier F2024Outpatient 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)1119301NANA 8447Carrier F2024Outpatient 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 minutes1119301NANA 8448Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0019Behavioral health; long-term residential (nonmedical, nonacute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem1111101NANA 8449Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)11101NANA 8450Carrier F2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0031Mental health assessment, by nonphysician1110201NANA 8451Carrier F2024Outpatient 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 hour1119301NANA 8452Carrier F2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCJ0578Injection, buprenorphine extended-release (Brixadi), greater than 7 days and up to 28 days of therapy30.332430NANA 8453Carrier F2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS0013Esketamine, nasal spray, 1 mg70.141010734NANA 8454Carrier F2024Outpatient 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 management500.12493842NANA 8455Carrier F2024Outpatient 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 management500.126921040NANA 8456Carrier F2024Outpatient 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 session650.0827891748NANA 8457Carrier F2024Outpatient 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 patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation330.063177825NANA 8458Carrier F2024Outpatient 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 patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation180.062873414NANA 8459Carrier F2024DMECodes 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 adjustment130.2308374112NANA 8460Carrier F2024DMECodes 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 accessories120.8333117012NANA 8461Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each120.8333117012NANA 8462Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable120.8333117012NANA 8463Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4604Tubing with integrated heating element for use with positive airway pressure device110.2727275138NANA 8464Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair component or accessory, not otherwise specified110.72731761110NANA 8465Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0562Humidifier, heated, used with positive airway pressure device100.322.4333334119NANA 8466Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA7030Full face mask used with positive airway pressure device, each90.333322.4333335918NANA 8467Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Continuous positive airway pressure (CPAP) device90.333322.4333334118NANA 8468Carrier F2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin90.88894309NANA 8469Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each615906NANA 8470Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Osteogenesis stimulator, electrical, noninvasive, spinal applications516005NANA 8471Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other516705NANA 8472Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1390Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate514505NANA 8473Carrier F2024DMECodes 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 diem518605NANA 8474Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466Home ventilator, any type, used with noninvasive interface, (e.g., mask, chest shell)4124.1166666213NANA 8475Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2620Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 in, any height, including any type mounting hardware417904NANA 8476Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCK0195Elevating legrests, pair (for use with capped rental wheelchair base)4120.9888882231NANA 8477Carrier F2024DMECodes 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 section418504NANA 8478Carrier F2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5673Addition to lower extremity, below knee (BK)/above knee (AK), custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism412804NANA 8479Carrier F2024DMECodes 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 diem50.28605NANA 8480Carrier F2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCB4150Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit60.16677306NANA 8481Carrier F2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip150.86670470015NANA 8482Carrier F2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip150.86670470015NANA 8483Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA2280.60090.672.76272010SemaglutideOzempic 8484Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA980.57140.032.8412860TirzepatideMounjaro 8485Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA890.73032.498.1911780RimegepantNurtec 8486Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA610.86896.0210.1913480DupilumabDupixent 8487Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA590.86440.273.0414450EmpagliflozinJardiance 8488Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA510.98040.021.376450GalcanezumabEmgality 8489Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA490.87762.737.2117320EvolocumabRepatha 8490Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA480.8750.253.736420EmpagliflozinJardiance 8491Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA390.76920.015.053360LiraglutideVictoza 8492Carrier F2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA370.70270.7713.017300RisankizumabSkyrizi 8493Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1817.0810.13150EtanerceptEnbrel 8494Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1010.010.24190ErenumabAimovig 8495Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1012.110.19280UstekinumabStelara 8496Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA10100.01370CariprazineVraylar 8497Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA8106.28170DapagliflozinFarxiga 8498Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA710.456.31250UbrogepantUbrelvy 8499Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA713.9711.09160NaltrexoneVivitrol 8500Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA6109.74150SitagliptinJanuvia 8501Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA615.916.95150AdalimumabHumira 8502Carrier F2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA6105.39150DenosumabProlia 8503Carrier F2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA10.33333.17010LeuprolideLupron 8504Carrier F2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA110.13010TestosteroneTestosterone 8505Carrier F2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA10.50.08010Buprenorphine-NaloxoneSuboxone 8506Carrier F2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA111.91100PatiromerVeltassa 8507Carrier F2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA110.93100FilgrastimNeupogen 8508Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearRevenue121Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN1500.366712.73095229.74685728122NANA 8509Carrier H2024Inpatient 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 Gastroent440.863617.454552044NANA 8510Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT43775Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy410.902416.2041NANA 8511Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int3111834.666656427NANA 8512Carrier H2024Inpatient 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), With310.9677012.444456229NANA 8513Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-Lateral,Ea Add.In1911239.529416217NANA 8514Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT63053Laminectomy, Facetectomy, Or Foraminotomy During Posterior Interbody Arthrodesis, Lumbar;160.687546.5016NANA 8515Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom1512460312NANA 8516Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22634Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn140.642939.428568014NANA 8517Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT27487Revis.Totl Knee Arthroplas,W/Wo Allogft;14105.538456113NANA 8518Carrier H2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT22614Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int3111834.666656427NANA 8519Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22585Arthrodesis, Anterior/-Lateral,Ea Add.In1911239.529416217NANA 8520Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom1512460312NANA 8521Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27487Revis.Totl Knee Arthroplas,W/Wo Allogft;14105.538456113NANA 8522Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19328Removal Of Intact Breast Implant111240110NANA 8523Carrier H2024Inpatient 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,10121.6010NANA 8524Carrier H2024Inpatient 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 Fem9134.66665609NANA 8525Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11971Removal Of Tissue Expander Without Insertion Of Implant91009NANA 8526Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27137Revision Total Hip-Acetabular Only91122427NANA 8527Carrier H2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27130Replacement Hip Total Simple716.85713607NANA 8528Carrier H2024Inpatient 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 Gastroent44117.454552044NANA 8529Carrier H2024Inpatient 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 Int3111834.666656427NANA 8530Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22585Arthrodesis, Anterior/-Lateral,Ea Add.In1911239.529416217NANA 8531Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom1512460312NANA 8532Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT33361Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem9134.66665609NANA 8533Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61863Burr Hole Craniotomy With Implantation Of Subcortical Electrode Array, Wo Intraop Microele6116.00000806NANA 8534Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43659Unlisted Laparoscopy Procedure, Stomach513005NANA 8535Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT61864Burr Hole Craniotomy W Implantation Of Subcortical Electrode Array, Wo Intraop Microelectr412404NANA 8536Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15879Suction Assist Lipectomy Lower Extremity112401NANA 8537Carrier H2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT15878Suction Assist Lipectomy Up Extrem112401NANA 8538Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93306Echo, Transthoracic W/Doppler, Complete387580.93261.3714295.8030633538723NANA 8539Carrier H2024Outpatient 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]345340.97291.665837034534NANA 8540Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73721Mri, Lower Extremity Any Joint; Wo Contr265410.87311.6901417.7703067126470NANA 8541Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPTMSMPTPhysical Therapy214200.68139NANA 8542Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72148Mri Of Lumbar Spine191370.87920.967.6458514919088NANA 8543Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT70553Mri Of Brain And Further Sequences184870.93822.0869575.0639344618441NANA 8544Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Ct Abd & Pelv W Contrast176620.93210.3380288.1159487117591NANA 8545Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT73221Mri, Any Joint Of Upper Extremity; Wo Co133750.85520.8888898.6916392713348NANA 8546Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT72141Mri Of Cervical Spine113180.87710.88.121182911289NANA 8547Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260Diagnostic Ct Thorax W/Contrast101230.942904.9346023110092NANA 8548Carrier H2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT95800Sleep Study, Unattended, Simultaneous Recording; Heart Rate, Oxygen Saturation, Respiratory Analysis (E.G., By Air Flow Or Peripheral Arterial Tone) And Sleep Time112100112NANA 8549Carrier H2024Outpatient 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/Or611014.89656160NANA 8550Carrier H2024Outpatient 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)45109.081072738NANA 8551Carrier H2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27446Arthropls,Knee,Cond/Plat;Medor Lat261019.999992224NANA 8552Carrier H2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT11970Replacement Of Tissue Expander With Permanent Implant20121.6020NANA 8553Carrier H2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT92250Fundus photography with interpretation and report3312.2166662.804166132NANA 8554Carrier H2024Outpatient 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 level27117.03666623.829545522NANA 8555Carrier H2024Outpatient 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 joint1912.99166632.22745217NANA 8556Carrier H2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99204Office or other outpatient visit for the evaluation and management of a new 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, 45 minutes must be met or exceeded.1910.0083332.043137217NANA 8557Carrier H2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93458Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed17116.45624970.99814789NANA 8558Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27447Replacement Knee Total3251014.55237610315NANA 8559Carrier H2024Outpatient 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, Ar89126.157312089NANA 8560Carrier H2024Outpatient 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 D791020.7475NANA 8561Carrier H2024Outpatient 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, Ar61122.426224061NANA 8562Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36482Endovenous Ablation Therapy Of Incompetent Vein, Extremity, By Transcatheter Delivery Of A56119.525416056NANA 8563Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22552Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom42114.442.162168537NANA 8564Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT67904Rep Blepharoptosis Levator External40121.142848040NANA 8565Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27446Arthropls,Knee,Cond/Plat;Medor Lat261019.999992224NANA 8566Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT36476Endovenous Ablation Tx Of Incompetent Vein, Extremity, Inclusive Imaging Guidance & Monito24121.12024NANA 8567Carrier H2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64582Open Implantation Of Hypoglossal Nerve Neurostimulator Array, Pulse Generator, And Distal22125.09092022NANA 8568Carrier H2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation2022.433333114.31666611NANA 8569Carrier H2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric2011.150.211NANA 8570Carrier H2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue126Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification203.95833320NANA 8571Carrier H2024Inpatient 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 management107.66666610NANA 8572Carrier H2024Inpatient 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 session107.66666610NANA 8573Carrier H2024Inpatient 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 management107.66666610NANA 8574Carrier H2024Inpatient 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 minutes1050.201NANA 8575Carrier H2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1022.1510NANA 8576Carrier H2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ2777Injection, faricimab-svoa, 0.1 mg1011.110NANA 8577Carrier H2024Inpatient MH-SUDCodes with the highest total number of 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 joint100.2510NANA 8578Carrier H2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenueNAAccommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation2022.433333114.31666611NANA 8579Carrier H2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue128Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric2011.150.211NANA 8580Carrier H2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification203.95833320NANA 8581Carrier H2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT126Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management107.66666610NANA 8582Carrier H2024Inpatient 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 session107.66666610NANA 8583Carrier H2024Inpatient 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 management107.66666610NANA 8584Carrier H2024Inpatient 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 minutes1050.201NANA 8585Carrier H2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1022.1510NANA 8586Carrier H2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ2777Injection, faricimab-svoa, 0.1 mg1011.110NANA 8587Carrier H2024Inpatient MH-SUDCodes 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 joint100.2510NANA 8588Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90868Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin2320.814716.61539236.42856813219NANA 8589Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90867Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica2000.84517.45455237.2063611189NANA 8590Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90869Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor1950.851316.00000835.80540812183NANA 8591Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental health partial hospitalization, treatment, less than 24 hours1490.798719.70714241.2558687142NANA 8592Carrier H2024Outpatient 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 plan1100.763618.07435871.8118551397NANA 8593Carrier H2024Outpatient 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 minutes1020.774522.90208370.110271686NANA 8594Carrier H2024Outpatient 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 minutes960.770821.22499968.5014221482NANA 8595Carrier H2024Outpatient 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 minutes950.768420.20714270.5744851481NANA 8596Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive outpatient psychiatric services, per diem690.695721.39999943.605472267NANA 8597Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0032Mental health service plan development by nonphysician520.769218.05416657.667707448NANA 8598Carrier H2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCS9480Intensive Outpatient Psychiatric Services Per Diem612457.615NANA 8599Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90837Psychotherapy, 60 Minutes With Patient5138.405NANA 8600Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90791Psychiatric Diagnostic Evaluation5152.805NANA 8601Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0020Alcohol And/Or Drug Services213602NANA 8602Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours21242411NANA 8603Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG2067Medication Assisted Treatment, Methadone; Weekly Bundle Including Dispensing And/Or Admini213602NANA 8604Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS0201Partial hospitalization services, less than 24 hours, per diem5167.78999905NANA 8605Carrier H2024Outpatient 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 Pr117201NANA 8606Carrier H2024Outpatient 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 Health117201NANA 8607Carrier H2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90834Psychotherapy; 45 Minutes With Patient117201NANA 8608Carrier H2024Outpatient 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 Patie420.714313.33334432.641824NANA 8609Carrier H2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS0013Esketamine, Nasal Spray, 1 Mg390.666710.28570435.5555441425NANA 8610Carrier H2024Outpatient 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, Includin2320.516.61539236.42856813219NANA 8611Carrier H2024Outpatient 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 Patie170.510.28570431.2710NANA 8612Carrier H2024Outpatient 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 Cortica2000.428617.45455237.2063611189NANA 8613Carrier H2024Outpatient 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 Motor1950.416.00000835.80540812183NANA 8614Carrier H2024Outpatient MH-SUDCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS9480Intensive Outpatient Psychiatric Services Per Diem602457.615NANA 8615Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral Device/Appliance Cusfab2260.98233.12896401645NANA 8616Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair Component Or Accessory, Not Otherwise Specified860.802324.505272086NANA 8617Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCS1040Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ700.957116.457136070NANA 8618Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8680Implantable Neurostimulator Electrode Each480.91672449.534872147NANA 8619Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Osteogenic Stimulator, Noninvasive, Spinal Applications330.6061099.096768132NANA 8620Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive32036.75032NANA 8621Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2620Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width250.9624025NANA 8622Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0652Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr250.7224.96025NANA 8623Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Osteogenesis Stimulator (Non-Invasive)240.416730.26088024NANA 8624Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair24121024NANA 8625Carrier H2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0005Ultralightweight Wheelchair24121024NANA 8626Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260Hospital Bed, Seimi-Electric (Head And Foot Adjustment), With Any Type9121.33333609NANA 8627Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8690Aud Osseo Dev, Int/Ext Comp8130.85713608NANA 8628Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Typ812108NANA 8629Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8687Implt Nrostm Pls Gen Dua Rec712419.99999216NANA 8630Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0465Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)7172.70714207NANA 8631Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8686Implt Nrostm Pls Gen Sng Non6114.406NANA 8632Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2609Custom Fabricated Wheelchair Seat Cushion, Any Size612406NANA 8633Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2617Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type512405NANA 8634Carrier H2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2607Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22411804NANA 8635Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCK0606Aed Garment With Electrocardiogram Analysis1116.545448110NANA 8636Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8614Cochlear Device/System10118.666672010NANA 8637Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE0483High Frequency Chest Wall Oscillation System, With Full Anterior And/Or Posterior Thoracic813308NANA 8638Carrier H2024DMECodes 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 Typ812108NANA 8639Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCL8686Implt Nrostm Pls Gen Sng Non6114.406NANA 8640Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2609Custom Fabricated Wheelchair Seat Cushion, Any Size612406NANA 8641Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2617Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type512405NANA 8642Carrier H2024DMECodes 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,5133.605NANA 8643Carrier H2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2607Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22411804NANA 8644Carrier H2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip520.55772.0172435779.67115380809430NANA 8645Carrier H2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearNANADiabetes Supplies & Equip520.55772.0172435779.67115380809430NANA 8646Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA22820.55130.942.8427020120SemaglutideOzempic 8647Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA12290.51590.52.3413510940TirzepatideMounjaro 8648Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA9150.76282.638.441637520RimegepantNurtec 8649Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA6630.76776.4216.21475160DupilumabDupixent 8650Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA5510.84750.892.931354160EmpagliflozinJardiance 8651Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4940.81581.635.76624320TirzepatideZepbound 8652Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA4150.80961.47.99803350UbrogepantUbrelvy 8653Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA3970.96470.422.06982990GalcanezumabEmgality 8654Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA3860.67360.652.08473390SemaglutideOzempic 8655Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA3660.85251.17.51643020EvolocumabRepatha 8656Carrier H2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearNDC9NANA15111.831.832130LinagliptinTradjenta 8657Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1414.5736.15950AcalabrutinibCalquence 8658Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA13111.868.36580GlatiramerGlatiramer 8659Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1211.6728.8480MacitentanOpsumit 8660Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1215.377.23660DabrafenbTafinlar 8661Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA12100.12100SitagliptinJanuvia 8662Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1110.010.01470CariprazineVraylar 8663Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1113.42.84650AbemaciclibVerzenio 8664Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA10103.35370Desvenlafaxine ErDesvenlafaxine Er 8665Carrier H2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearNDC9NANA1010.017.38280LemborexantDayvigo 8666Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA170.11041.0815.145120DupilumabDupixent 8667Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA110.12941.8818.69290RisankizumabSkyrizi 8668Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA80.05160.5833.49260RuxolitinibOpzelura 8669Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA80.0361.8928.27170RifaximinXifaxan 8670Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA50.156318.97050DupilumabDupixent 8671Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA50.21.2422.49230AdalimumabHumira 8672Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA40.04435.02040TirzepatideZepbound 8673Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA40.28571.08040DupilumabDupixent 8674Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA40.00390.610.93220SemaglutideOzempic 8675Carrier H2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealNDC9NANA40.102618.2118.53220GuselkumabTremfya 8676Carrier J2024Inpatient 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)560.714372.1819444483.59531313392.74732781542NANA 8677Carrier J2024Inpatient 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 pump3601.8225231481.4731712962412NANA 8678Carrier J2024Inpatient 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)300.766772.1819444493.57715517129NANA 8679Carrier J2024Inpatient 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); lumbar290.827677.56280651150.502625291NANA 8680Carrier J2024Inpatient 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)280.821419.9818055689.5417735394.0098332269NANA 8681Carrier J2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis2701.4666666670.381068376126NANA 8682Carrier J2024Inpatient 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)270.777813.3929629685.30444444291.98454943243NANA 8683Carrier J2024Inpatient 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; lumbar260.769272.1819444480.61262222634.99203061251NANA 8684Carrier J2024Inpatient 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)250.8819.9818055690.31719807441.14244982239NANA 8685Carrier J2024Inpatient 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)2200.22205555619.85996732517NANA 8686Carrier J2024Inpatient 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 segment9196.5891358574.781999994NANA 8687Carrier J2024Inpatient 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; lumbar7139.75888889114.7148148613.1345389161NANA 8688Carrier J2024Inpatient 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)7139.7588888973.30351852377.0117495164NANA 8689Carrier J2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22212Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic6169.373333336NANA 8690Carrier J2024Inpatient 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)5183.21033333646.783148652NANA 8691Carrier J2024Inpatient 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; cervical4148.646805564NANA 8692Carrier J2024Inpatient 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 allograft4129.90104167278.527239741NANA 8693Carrier J2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64999Unlisted procedure, nervous system3134.146574073NANA 8694Carrier J2024Inpatient 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)31117.9865741413.571507635NANA 8695Carrier J2024Inpatient 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 segments3122.18925926658.574266731NANA 8696Carrier J2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38241Hematopoietic progenitor cell (HPC); autologous transplantation3145.899351853NANA 8697Carrier J2024Inpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft40.25129.3272222270.809755142NANA 8698Carrier J2024Inpatient 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)300.172.1819444493.57715517129NANA 8699Carrier J2024Inpatient 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; lumbar260.076972.1819444480.61262222634.99203061251NANA 8700Carrier J2024Inpatient 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)560.035772.1819444483.59531313392.74732781542NANA 8701Carrier J2024Outpatient 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 echocardiography37910.94781.0286111113.940282249503.8950169137907NANA 8702Carrier J2024Outpatient 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)35200.97640.662023812.429828867336.05533798434364NANA 8703Carrier J2024Outpatient 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 minutes33430.89950.15513888911.93305797437.70336114333972NANA 8704Carrier J2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple31710.97540.5826420452.327970176422.679631688308316NANA 8705Carrier J2024Outpatient 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 flexibility28610.907714.7636111111.6278291433.41460593285865NANA 8706Carrier J2024Outpatient 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 material28180.86161.1189285717.650428059513.54612271428024NANA 8707Carrier J2024Outpatient 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 technique27640.98010.6005354752.302260586325.343449583268117NANA 8708Carrier J2024Outpatient 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 activities27110.900414.4657407410.55316152397.58850533270854NANA 8709Carrier J2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Computed tomography, abdomen and pelvis; with contrast material(s)25560.95662.2696464653.571261842509.763837111254511NANA 8710Carrier J2024Outpatient 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 minutes24190.90788.91572222211.27250771374.61923235241436NANA 8711Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT20680Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)5510.0802777786.366172839421.21789011548NANA 8712Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43260Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)3611.0811111115.748404762464.94079641351NANA 8713Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT43261Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple2611.0811111117.7606125NANA 8714Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52224Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy2510.9608333330.22625124NANA 8715Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32408Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed2511.38296296314.92536616322NANA 8716Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21230Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)25130.3137333325NANA 8717Carrier J2024Outpatient 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 processing2310.16495169123NANA 8718Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52214Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands2310.9608333330.066767677122NANA 8719Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT27792Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed2310.0879629630.041944444323.371739142NANA 8720Carrier J2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32555Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance2211.0064814816.600102339258.2473093193NANA 8721Carrier J2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT64555Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)30.66676.6559259263NANA 8722Carrier J2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72295Discography, lumbar, radiological supervision and interpretation30.3333136.30842593NANA 8723Carrier J2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT27420Reconstruction of dislocating patella; (eg, Hauser type procedure)30.333387.744259263NANA 8724Carrier J2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT43497Lower esophageal myotomy, transoral30.3333106.187777884.6465277812NANA 8725Carrier J2024Outpatient 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)40.25126.4635417313.2741NANA 8726Carrier J2024Outpatient 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)150.293.9306481515NANA 8727Carrier J2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT29897Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited50.214.366666675NANA 8728Carrier J2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT22514Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar50.2116.2152778347.177439352NANA 8729Carrier J2024Outpatient 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; lumbar50.2102.60716675NANA 8730Carrier J2024Outpatient 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)90.111197.37151235395.920570493NANA 8731Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder670.940347.1422222236.960194608.65480831661NANA 8732Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric330.666724.823796343.85863027330NANA 8733Carrier J2024Inpatient 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 approach170.764749.4128431417NANA 8734Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state170.823557.5743300717NANA 8735Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53430Urethroplasty, reconstruction of female urethra160.812550.8068229216NANA 8736Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete150.853.156703715NANA 8737Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state140.857154.6219047614NANA 8738Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55175Scrotoplasty; simple120.833346.2822916712NANA 8739Carrier J2024Inpatient 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 cm60.166735.131256NANA 8740Carrier J2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric6128.2925619.920537564NANA 8741Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue124Room and board, Semi-Private, Psychiatric6128.2925619.920537564NANA 8742Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra2190.706527782NANA 8743Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue126Room and board, Semi Private Detoxification2182.415833332NANA 8744Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76857Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)11162.10472221NANA 8745Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved 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 less11162.10472221NANA 8746Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57106Vaginectomy, partial removal of vaginal wall;11162.10472221NANA 8747Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56620Vulvectomy simple; partial11162.10472221NANA 8748Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT51102Aspiration of bladder; with insertion of suprapubic catheter11162.10472221NANA 8749Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56800Plastic repair of introitus1115.558611111NANA 8750Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT13131Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm11162.10472221NANA 8751Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT55180Scrotoplasty; complicated11162.10472221NANA 8752Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56810Perineoplasty, repair of perineum, nonobstetrical (separate procedure)11162.10472221NANA 8753Carrier J2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53450Urethromeatoplasty, with mucosal advancement11162.10472221NANA 8754Carrier J2024Outpatient 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)3160.94622.147284634653.53162NANA 8755Carrier J2024Outpatient 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 session1850.89735.66597222221.190448844181NANA 8756Carrier J2024Outpatient 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 management1760.89777.54972222221.64865223173NANA 8757Carrier J2024Outpatient 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; individual1740.798916.0210185258.17794347274.4116901317123NANA 8758Carrier J2024Outpatient 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 management1570.89177.54972222219.7580888954531541NANA 8759Carrier J2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services1530.97393.12716666715.8923908711142NANA 8760Carrier J2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours870.850636.7908333387NANA 8761Carrier J2024Outpatient 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 plan470.42552.152557.3347619245NANA 8762Carrier J2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete450.88891.9438.54463384144NANA 8763Carrier J2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction430.88371.9446.10008808142NANA 8764Carrier J2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15773Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate13131.1089957313NANA 8765Carrier J2024Outpatient 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 flexibility7129.091071437NANA 8766Carrier J2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15774Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separately in addition to code for primary procedure)7139.749007947NANA 8767Carrier J2024Outpatient 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 activities7127.1334127489.638942571NANA 8768Carrier J2024Outpatient 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 approach6146.111064816NANA 8769Carrier J2024Outpatient 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)5110.546555565NANA 8770Carrier J2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15828Rhytidectomy; cheek, chin, and neck5115.990055565NANA 8771Carrier J2024Outpatient 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)5124.338333335NANA 8772Carrier J2024Outpatient 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 analysis5110.546555565NANA 8773Carrier J2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT70450Computed tomography, head or brain; without contrast material410.0004166674NANA 8774Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device42100.96291.743706651486.015033742103NANA 8775Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate2700.96672.388569959270NANA 8776Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate880.97731.07749368788NANA 8777Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable410.390261.6018091241NANA 8778Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi4000.14555555616.40201754139NANA 8779Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other20014.889520NANA 8780Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor170.294129.6462091517NANA 8781Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0955Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each16018.3313020816NANA 8782Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine140.142935.7269444414NANA 8783Carrier J2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal130.3077133.964786313NANA 8784Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766ELEC STIM CANCER TREATMENT513.2162515.9013888923NANA 8785Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate880.97731.07749368788NANA 8786Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate2700.96672.388569959270NANA 8787Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device42100.96291.743706651486.015033742103NANA 8788Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0466HOME VENT NON-INVASIVE INTER60.53.89333333324.378515NANA 8789Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable410.390261.6018091241NANA 8790Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal130.3077133.964786313NANA 8791Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor170.294129.6462091517NANA 8792Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab60.16671.2644444446.19583333315NANA 8793Carrier J2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine140.142935.7269444414NANA 8794Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml1900.0086111110.429135802118NANA 8795Carrier J2024Diabetes 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 supply603.3237222226NANA 8796Carrier J2024Diabetes 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 system403.9327777784NANA 8797Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin304.1494444443NANA 8798Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4211Supp For Self-Adm Injections201.3755555562NANA 8799Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service2020.758611112NANA 8800Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl101.7213888891NANA 8801Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA5500Diab Shoe For Density Insert100.0088888891NANA 8802Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103Non-adjunctive, non-implanted continuous glucose monitor or receiver1023.592222221NANA 8803Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc101.7213888891NANA 8804Carrier J2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4238Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service1017.9251NANA 8805Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4216Sterile water/saline, 10 ml1900.0086111110.429135802118NANA 8806Carrier J2024Diabetes 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 supply603.3237222226NANA 8807Carrier J2024Diabetes 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 system403.9327777784NANA 8808Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784Ext Amb Infusn Pump Insulin304.1494444443NANA 8809Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4211Supp For Self-Adm Injections201.3755555562NANA 8810Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service2020.758611112NANA 8811Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4230Infus Insulin Pump Non Needl101.7213888891NANA 8812Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA5500Diab Shoe For Density Insert100.0088888891NANA 8813Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2103Non-adjunctive, non-implanted continuous glucose monitor or receiver1023.592222221NANA 8814Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4232Syringe W/Needle Insulin 3cc101.7213888891NANA 8815Carrier J2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4238Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service1017.9251NANA 8816Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA15410.032446.689.361501391SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 8817Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA13240.003863.916.481201204TIRZEPATIDE (WEIGHT MANAGEMENT)ZEPBOUND 8818Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA11130.730510.6626.14391722HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN 8819Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA11000.63736.847.03175925SEMAGLUTIDEOZEMPIC (0.25 OR 0.5 MG/DOSE), OZEMPIC (1 MG/DOSE), OZEMPIC (2 MG/DOSE), RYBELSUS 8820Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA10560.76997.7517.04395661OXYCODONE HCLOXYCODONE HCL, OXYCODONE HCL ER, OXYCONTIN, ROXICODONE 8821Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA8590.56698.936.3399760TIRZEPATIDEMOUNJARO, MOUNJARO SUBCUTANEOUS SOLUTION PEN-INJECTOR 2.5 MG/0.5ML 8822Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA7560.72357.3213.1850706CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, CYCLOSPORINE IN KLARITY, KLARITY-C DROPS, RESTASIS, RESTASIS MULTIDOSE, VEVYE 8823Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6750.908118.3816.89190485ADALIMUMABHUMIRA (2 PEN), HUMIRA (2 PEN) SUBCUTANEOUS PEN-INJECTOR KIT 40 MG/0.4ML, HUMIRA (2 SYRINGE), HUMIRA-CD/UC/HS STARTER, HUMIRA-PED<40KG CROHNS STARTER, HUMIRA-PED>/=40KG UC STARTER, HUMIRA-PSORIASIS/UVEIT STARTER 8824Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6070.89138.9121.95147460DUPILUMABDUPIXENT 8825Carrier J2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4210.73420.7724.89171250OXYCODONE W/ ACETAMINOPHENENDOCET, OXYCODONE-ACETAMINOPHEN, PERCOCET 8826Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA3116.917.741912LUMATEPERONE TOSYLATECAPLYTA 8827Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2711.934.02225VARENICLINE TARTRATEVARENICLINE TARTRATE, VARENICLINE TARTRATE (STARTER) 8828Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2116.086.43417CARBIDOPA-LEVODOPACARBIDOPA-LEVODOPA, RYTARY, SINEMET 8829Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1716.5311.08134AMPHETAMINEADZENYS XR-ODT, DYANAVEL XR 8830Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1614.433.42511CONTINUOUS GLUCOSE SYSTEM RECEIVERDEXCOM G6 RECEIVER, DEXCOM G7 RECEIVER, FREESTYLE LIBRE 2 READER 8831Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1317.012.1285TOLVAPTANJYNARQUE, TOLVAPTAN 8832Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1214.652.15102RUXOLITINIB PHOSPHATEJAKAFI 8833Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1213.62012ACOLTREMONTRYPTYR 8834Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1212.449.966ESCITALOPRAM OXALATEESCITALOPRAM OXALATE, LEXAPRO 8835Carrier J2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1215.56.6939PAROXETINE HCLPAROXETINE HCL, PAROXETINE HCL ER 8836Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA815.4748.4817DEXTROMETHORPHAN HYDROBROMIDE-BUPROPION HYDROCHLORIDEAUVELITY 8837Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA614.7460.8324PRUCALOPRIDE SUCCINATEMOTEGRITY 8838Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA5110.8199.0323BUPRENORPHINEBUPRENORPHINE, BUTRANS 8839Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA4122.0243.0513TOFACITINIB CITRATEXELJANZ, XELJANZ XR 8840Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA4160.7871.7731APREMILASTOTEZLA 8841Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3111.6430SUVOREXANTBELSOMRA 8842Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3122.9730TIVOZANIB HCLFOTIVDA 8843Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3116.3141.6121ERENUMAB-AOOEAIMOVIG 8844Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA3168.6203MORPHINE SULFATEMORPHINE SULFATE ER 8845Carrier J2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2132.1720IVOSIDENIBTIBSOVO 8846Carrier I2024Inpatient 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 ileocolostomy1001.2816666670.80423611128NANA 8847Carrier I2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44206Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)900.6210185199NANA 8848Carrier I2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT44204Laparoscopy, surgical; colectomy, partial, with anastomosis900.6743827169NANA 8849Carrier I2024Inpatient 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)800.6974652788NANA 8850Carrier I2024Inpatient 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)80.7550.681736118NANA 8851Carrier I2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64421Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure)600.66388888990.5977222215NANA 8852Carrier I2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31622Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)600.66388888990.5976111115NANA 8853Carrier I2024Inpatient 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)50.663.06127778474.575597251NANA 8854Carrier I2024Inpatient 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;50.24.3401111115NANA 8855Carrier I2024Inpatient 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)401.3848611114NANA 8856Carrier I2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45330Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)400.8418055564NANA 8857Carrier I2024Inpatient 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)40.7543.753263894NANA 8858Carrier I2024Inpatient 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)40.7543.75326389474.575597241NANA 8859Carrier I2024Inpatient 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 allograft310.074259259689.407980631NANA 8860Carrier I2024Inpatient 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 C22183.507083332NANA 8861Carrier I2024Inpatient 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)2181.268472222NANA 8862Carrier I2024Inpatient 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; lumbar2181.268472222NANA 8863Carrier I2024Inpatient 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)2183.507083332NANA 8864Carrier I2024Inpatient 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)2123.0675322.789533922NANA 8865Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37241Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)1126.067222221NANA 8866Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT37246Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery11118.10916671NANA 8867Carrier I2024Inpatient 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; allogeneic1120.561388891NANA 8868Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38240Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor1120.561388891NANA 8869Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61863Twist 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), without use of intraoperative microelectrode recording; first array1125.623055561NANA 8870Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38724Cervical lymphadenectomy (modified radical neck dissection)111.1816666671NANA 8871Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63005Laminectomy 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; lumbar, except for spondylolisthesis11123.00166671NANA 8872Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT63277Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar11123.00166671NANA 8873Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT39599Unlisted procedure, diaphragm11135.33055561NANA 8874Carrier I2024Inpatient 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)1147.833888891NANA 8875Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT61864Twist 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), without use of intraoperative microelectrode recording; each additional array (List separately in addition to primary procedure)1125.623055561NANA 8876Carrier I2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT22999Unlisted procedure, abdomen, musculoskeletal system11144.77805561NANA 8877Carrier I2024Inpatient 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 allograft1151.216388891NANA 8878Carrier I2024Inpatient 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; lumbar11123.00166671NANA 8879Carrier I2024Inpatient 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)11111.11NANA 8880Carrier I2024Inpatient 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 age1126.21NANA 8881Carrier I2024Outpatient 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 echocardiography3790.90247.120237467379NANA 8882Carrier I2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT74177Computed tomography, abdomen and pelvis; with contrast material(s)2850.922818.372777787.452548905551.809479712842NANA 8883Carrier I2024Outpatient 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 sequences2670.90649.777399084267NANA 8884Carrier I2024Outpatient 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 material1840.73919.766171498184NANA 8885Carrier I2024Outpatient 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 material1760.70452.75685185225.611942843173NANA 8886Carrier I2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71260Computed tomography, thorax, diagnostic; with contrast material(s)1430.91619.785207848562.24204361431NANA 8887Carrier I2024Outpatient 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)1410.9221.1905555562.6856427414137NANA 8888Carrier I2024Outpatient 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 flexibility1370.91973.426849148328.42105651374NANA 8889Carrier I2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT45380Colonoscopy, flexible; with biopsy, single or multiple1260.91271.1905555562.792313297340.224994741223NANA 8890Carrier I2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT71250Computed tomography, thorax, diagnostic; without contrast material1230.829313.90338753123NANA 8891Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74170Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections2411.27216435224NANA 8892Carrier I2024Outpatient 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 material1615.18425347216NANA 8893Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64484Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)1311.91371794913NANA 8894Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58572Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;12114.0486111114.83073232111NANA 8895Carrier I2024Outpatient 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 report1110.00045454511NANA 8896Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT78816Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body11131.0187626311NANA 8897Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72192Computed tomography, pelvis; without contrast material10124.2224166710NANA 8898Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT72193Computed tomography, pelvis; with contrast material(s)1014.62338888910NANA 8899Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31624Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage1010.8669444441.13018518546NANA 8900Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58662Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method9114.93222222288.266281395NANA 8901Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77078Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)912.3632407419NANA 8902Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT74174Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing915.3045679019NANA 8903Carrier I2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT38222Diagnostic bone marrow; biopsy(ies) and aspiration(s)910.2970555560.21554NANA 8904Carrier I2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70470Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections50.24.2023888895NANA 8905Carrier I2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT73222Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)180.055612.9974845718NANA 8906Carrier I2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72148Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material1760.0172.75685185225.611942843173NANA 8907Carrier I2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT72141Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material1210.008319.36479109517.61611111211NANA 8908Carrier I2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT70553Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences2670.00379.777399084267NANA 8909Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder8149.47968758NANA 8910Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearRevenue1001Residential treatment, Psychiatric40.7545.394652784NANA 8911Carrier I2024Inpatient 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 less200.2440277782NANA 8912Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state2153.597083332NANA 8913Carrier I2024Inpatient 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 approach2153.597083332NANA 8914Carrier I2024Inpatient MH-SUDCodes 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)200.2440277782NANA 8915Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra2153.597083332NANA 8916Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT15876Suction assisted lipectomy; head and neck1147.323611111NANA 8917Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54550Exploration for undescended testis (inguinal or scrotal area)100.0172222221NANA 8918Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54530Orchiectomy, radical, for tumor; inguinal approach100.0172222221NANA 8919Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state1199.861666671NANA 8920Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT55150Resection of scrotum100.4708333331NANA 8921Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant1199.861666671NANA 8922Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT49329Unlisted laparoscopy procedure, abdomen, peritoneum and omentum117.33251NANA 8923Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT57425Laparoscopy, surgical, colpopexy (suspension of vaginal apex)100.4708333331NANA 8924Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT58999Unlisted procedure, female genital system (nonobstetrical)117.33251NANA 8925Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete117.33251NANA 8926Carrier I2024Inpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT54120Amputation of penis; partial100.0172222221NANA 8927Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearRevenue1002Residential treatment, Substance Use Disorder8149.47968758NANA 8928Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT56805Clitoroplasty for intersex state2153.597083332NANA 8929Carrier I2024Inpatient 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 approach2153.597083332NANA 8930Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT53410Urethroplasty, 1-stage reconstruction of male anterior urethra2153.597083332NANA 8931Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15876Suction assisted lipectomy; head and neck1147.323611111NANA 8932Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT57335Vaginoplasty for intersex state1199.861666671NANA 8933Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19325Breast augmentation with implant1199.861666671NANA 8934Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49329Unlisted laparoscopy procedure, abdomen, peritoneum and omentum117.33251NANA 8935Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT58999Unlisted procedure, female genital system (nonobstetrical)117.33251NANA 8936Carrier I2024Inpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT54125Amputation of penis; complete117.33251NANA 8937Carrier I2024Outpatient 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 session180.666719.4933333318.5529085117NANA 8938Carrier I2024Outpatient 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 management180.666719.4933333318.5529085117NANA 8939Carrier I2024Outpatient 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 management170.647119.4933333319.34711806116NANA 8940Carrier I2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services100.915.2219444410.4775308619NANA 8941Carrier I2024Outpatient 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)100.711.5267222210NANA 8942Carrier I2024Outpatient 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; individual60.666751.507175936NANA 8943Carrier I2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT19318Breast reduction413.0647222224NANA 8944Carrier I2024Outpatient 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 plan40.2524.150555564NANA 8945Carrier I2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT17380Electrolysis epilation, each 30 minutes40.75331.85722224NANA 8946Carrier I2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem3110.65253NANA 8947Carrier I2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT81415Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis303.8948148153NANA 8948Carrier I2024Outpatient 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)30.666773.428240743NANA 8949Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction413.0647222224NANA 8950Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH2036Alcohol and/or other drug treatment program, per diem3110.65253NANA 8951Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19350Nipple/areola reconstruction214.0013888892NANA 8952Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19303Mastectomy, simple, complete214.0013888892NANA 8953Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0035Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours2116.087777782NANA 8954Carrier I2024Outpatient 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 flexibility112.0055555561NANA 8955Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97535Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes112.0055555561NANA 8956Carrier I2024Outpatient 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 minutes112.0055555561NANA 8957Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT97152Behavior 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 minutes113.0569444441NANA 8958Carrier I2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCH0015Alcohol And/Or Drug Services100.915.2219444410.4775308619NANA 8959Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device3720.94092.449742384440.46425643721NANA 8960Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate130.84624.69023504313NANA 8961Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi501.4433333330.3587514NANA 8962Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab202.5401388892NANA 8963Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable20.541.279305562NANA 8964Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1236Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System102.24251NANA 8965Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height101.4422222221NANA 8966Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0766ELEC STIM CANCER TREATMENT1127.066944441NANA 8967Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate110.0002777781NANA 8968Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other101.4422222221NANA 8969Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods108.1933333331NANA 8970Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0691Ultraviolet Light Therapy System Panel, Includes Bulbs/Lamps, Timer An1023.185277781NANA 8971Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2619Replace cover w/c seat cush100.2944444441NANA 8972Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine1051.394722221NANA 8973Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2512Accessory for speech generating device, mounting system108.1933333331NANA 8974Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal100.09251NANA 8975Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0260Hosp Bed Semi-Electr W/ Matt1021.639722221NANA 8976Carrier I2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor101.5447222221NANA 8977Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0766ELEC STIM CANCER TREATMENT1127.066944441NANA 8978Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0471Respiratory assist device, bi-level pressure capability, with back-up rate110.0002777781NANA 8979Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0601Cont Airway Pressure Device3720.94092.449742384440.46425643721NANA 8980Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0470Respiratory assist device, bi-level pressure capability, without backup rate130.84624.69023504313NANA 8981Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable20.541.279305562NANA 8982Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable Medical Equipment Mi501.4433333330.3587514NANA 8983Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0486Oral device/appliance cusfab202.5401388892NANA 8984Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1236Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System102.24251NANA 8985Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0973Wheelchair Adjustabl Height101.4422222221NANA 8986Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other101.4422222221NANA 8987Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods108.1933333331NANA 8988Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0691Ultraviolet Light Therapy System Panel, Includes Bulbs/Lamps, Timer An1023.185277781NANA 8989Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2619Replace cover w/c seat cush100.2944444441NANA 8990Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0747Elec Osteogen Stim Not Spine1051.394722221NANA 8991Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2512Accessory for speech generating device, mounting system108.1933333331NANA 8992Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0748Elec Osteogen Stim Spinal100.09251NANA 8993Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0260Hosp Bed Semi-Electr W/ Matt1021.639722221NANA 8994Carrier I2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogen Ultrasound Stimltor101.5447222221NANA 8995Carrier I2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103Non-adjunctive, non-implanted continuous glucose monitor or receiver105.2030555561NANA 8996Carrier I2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service102.0747222221NANA 8997Carrier I2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2103Non-adjunctive, non-implanted continuous glucose monitor or receiver105.2030555561NANA 8998Carrier I2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service102.0747222221NANA 8999Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1140.675413.1614.953183HYDROCODONE-ACETAMINOPHENHYDROCODONE-ACETAMINOPHEN 9000Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1070.03745.17.11899SEMAGLUTIDE (WEIGHT MANAGEMENT)WEGOVY 9001Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1070.65428.5520.011988SEMAGLUTIDEOZEMPIC (0.25 OR 0.5 MG/DOSE), OZEMPIC (1 MG/DOSE), OZEMPIC (2 MG/DOSE), RYBELSUS 9002Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1030.74765.9627.273667OXYCODONE HCLOXYCODONE HCL, OXYCODONE HCL ER, OXYCONTIN 9003Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA700.64297.296.75367CYCLOSPORINE (OPHTH)CEQUA, CYCLOSPORINE, RESTASIS, RESTASIS MULTIDOSE, VEVYE 9004Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA6805.397.39959TIRZEPATIDE (WEIGHT MANAGEMENT)ZEPBOUND 9005Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA540.74075.883.53846TIRZEPATIDEMOUNJARO 9006Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA440.79554.4146.12539RIMEGEPANT SULFATENURTEC 9007Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA440.97736.1912.751133ADALIMUMABHUMIRA (2 PEN), HUMIRA (2 SYRINGE), HUMIRA-CD/UC/HS STARTER, HUMIRA-PED<40KG CROHNS STARTER 9008Carrier I2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA360.444420.269.22432LINACLOTIDELINZESS 9009Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2518.08025RISANKIZUMAB-RZAASKYRIZI, SKYRIZI PEN 9010Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1814.652.98414PLECANATIDETRULANCE 9011Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1312.074.73211SECUKINUMABCOSENTYX SENSOREADY (300 MG), COSENTYX SENSOREADY PEN, COSENTYX UNOREADY 9012Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1112.276.4338ETANERCEPTENBREL MINI, ENBREL SURECLICK 9013Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA911.936.5845ABEMACICLIBVERZENIO 9014Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA811.786.0726DULAGLUTIDETRULICITY 9015Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA711.967.2734LUMATEPERONE TOSYLATECAPLYTA 9016Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA717.2907LIFITEGRASTXIIDRA 9017Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA712.496.2534LAMOTRIGINELAMOTRIGINE, LAMOTRIGINE ER 9018Carrier I2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA612.533.0624ELTROMBOPAG OLAMINEPROMACTA 9019Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA4124.7829.1831EVOLOCUMABREPATHA SURECLICK 9020Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2112.2420ADALIMUMABHUMIRA (2 PEN) 9021Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2125.6502PENTOSAN POLYSULFATE SODIUMELMIRON 9022Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2116.5446.9911OXYCODONE W/ ACETAMINOPHENOXYCODONE-ACETAMINOPHEN 9023Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA214.5120IVABRADINE HCLCORLANOR 9024Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA2147.2802ERENUMAB-AOOEAIMOVIG 9025Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1121.8101RIBOCICLIB SUCCINATEKISQALI (600 MG DOSE) 9026Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1115.710SEMAGLUTIDEOZEMPIC (0.25 OR 0.5 MG/DOSE) 9027Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA1123.0801BUTORPHANOL TARTRATEBUTORPHANOL TARTRATE 9028Carrier I2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA115.4210BUPRENORPHINEBUPRENORPHINE 9029Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32666THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT3112NANA 9030Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT32674THORCOSCPY W/MEDIASTINL AND REGIONL LYMPHDENECTOMY30.33333NANA 9031Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33259ATRIA ABLTJ AND RCNSTJ W/OTHER PX EXTEN W/BYPASS3112NANA 9032Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33405RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT313NANA 9033Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33427VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING3112NANA 9034Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT35371TEAEC W/WO PATCH GRAFT COMMON FEMORAL313NANA 9035Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93355ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN313NANA 9036Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33340PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT212NANA 9037Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH2111NANA 9038Carrier G2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT33413REPLACEMENT AORTIC AND PULMON VALVES ROSS PROCEDUR212NANA 9039Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT32666THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT3112NANA 9040Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33259ATRIA ABLTJ AND RCNSTJ W/OTHER PX EXTEN W/BYPASS3112NANA 9041Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33405RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT313NANA 9042Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33427VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING3112NANA 9043Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT35371TEAEC W/WO PATCH GRAFT COMMON FEMORAL313NANA 9044Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93355ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN313NANA 9045Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33340PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT212NANA 9046Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33361REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH2113NANA 9047Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33413REPLACEMENT AORTIC AND PULMON VALVES ROSS PROCEDUR212NANA 9048Carrier G2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT33416VENTRICULOMYOTOMY-MYECTOMY2111NANA 9049Carrier G2024Outpatient 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 D12160.9622171199NANA 9050Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93971DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY2080.980812196NANA 9051Carrier G2024Outpatient 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 R2030.9362201NANA 9052Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93248EXTERNAL ECG REC GT 7D LT 15D REVIEW AND INTERPRETATION2010.9851201NANA 9053Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT78452MYOCARDIAL SPECT MULTIPLE STUDIES1920.92713189NANA 9054Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93246EXTERNAL ECG REC GT 7D LT 15D RECORDING1750.9829175NANA 9055Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93017CV STRS TST XERS AND /OR RX CONT ECG TRCG ONLY1700.9471170NANA 9056Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT93970DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY1560.94874152NANA 9057Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77334TX DEVICES DESIGN AND CONSTRUCTION COMPLEX1540.97414140NANA 9058Carrier G2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT77300BASIC RADIATION DOSIMETRY CALCULATION1390.978410129NANA 9059Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77301NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS781672NANA 9060Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77338MLC IMRT DESIGN AND CONSTRUCTION PER IMRT PLAN751669NANA 9061Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77014CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT731370NANA 9062Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93325DOP ECHOCARD COLOR FLOW VELOCITY MAPPING72172NANA 9063Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93308ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD63163NANA 9064Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93922NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL521349NANA 9065Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77332TX DEVICES DESIGN AND CONSTRUCTION SIMPLE351134NANA 9066Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT77386INTENSITY MODULATED RADIATION TX DLVR COMPLEX341232NANA 9067Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93290INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON31131NANA 9068Carrier G2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT93280PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER27127NANA 9069Carrier G2024Outpatient Med-SurgCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealCPT93970DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY10.004801NANA 9070Carrier G2024Outpatient 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 AND COLR D20.001602NANA 9071Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT90875INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN111NANA 9072Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96116NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR10111NANA 9073Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96121NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR10111NANA 9074Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96132NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR10111NANA 9075Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96133NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR10111NANA 9076Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96136PSYL/NRPSYCL TST PHYS/QHP 2 PLUS TST 1ST 30 MIN10111NANA 9077Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96137PSYCL/NRPSYCL TST PHYS/QHP 2 PLUS TST EA ADDL 30 MIN10111NANA 9078Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96138PSYCL/NRPSYCL TST TECH 2 PLUS TST 1ST 30 MIN10111NANA 9079Carrier G2024Outpatient MH-SUDCodes with the highest total number of prior authorization requests during the previous plan yearCPT96139PSYCL/NRPSYCL TST TECH 2 PLUS TST EA ADDL 30 MIN10111NANA 9080Carrier G2024Outpatient MH-SUDCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT90875INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN111NANA 9081Carrier G2024DMECodes 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 RATE616NANA 9082Carrier G2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTK0738PORTABLE GASEOUS O2 SYS RENTAL; HOME COMPRESSOR515NANA 9083Carrier G2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS111NANA 9084Carrier G2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTL3933FINGER ORTHOSIS W/O JOINTS CUSTOM FABRICATED111NANA 9085Carrier G2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTA4649SURGICAL SUPPLY; MISCELLANEOUS111NANA 9086Carrier G2024DMECodes with the highest total number of prior authorization requests during the previous plan yearCPTE2298COMPLEX REHAB PWR WC ACC PWR SEAT EL SYS ANY TYP111NANA 9087Carrier G2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE1390O2 CONC 1 DEL PORT 85 PCT OR GT 02 CONC AT PRSC FLW RATE616NANA 9088Carrier G2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTK0738PORTABLE GASEOUS O2 SYS RENTAL; HOME COMPRESSOR515NANA 9089Carrier G2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL0650LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS111NANA 9090Carrier G2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTL3933FINGER ORTHOSIS W/O JOINTS CUSTOM FABRICATED111NANA 9091Carrier G2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTA4649SURGICAL SUPPLY; MISCELLANEOUS111NANA 9092Carrier G2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearCPTE2298COMPLEX REHAB PWR WC ACC PWR SEAT EL SYS ANY TYP111NANA 9093Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA11240.89811.120.9325799AMPHETAMINE/DEXTROAMPHETAMINEADDERALL 9094Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA8680.51422.665.4237631DEXCOM Receiver/Sensor/TransmiterDEXCOM Receiver/Sensor/Transmiter 9095Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA5260.51318.738.891435SEMAGLUTIDEOZEMPIC 9096Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4680.82514.324.2130338METHYLPHENIDATE HCLRITALIN 9097Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3810.5227.759.9100281LISDEXAMFETAMINE DIMESYLATEVYVANSE 9098Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2900.73113.430.682208ADALIMUMABHUMIRA 9099Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2110.46432.162.610201TRETINOINRETIN-A 9100Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1990.24140.661.737162TERZEPATIDEMOUNJARO 9101Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1910.57128.742.76185TACROLIMUSPROTOPIC 9102Carrier G2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1890.79413.725.544145EMPAGLIFLOZINJARDIANCE 9103Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2218.617.6616PANCRELIPASECREON 9104Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA2111.428219GUSELKUMABTREMFYA 9105Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1614.31.2115CENOBAMATEXCORPI 9106Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10112.114.137CARBIDOPA/LEVODOPARYTARY 9107Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA10111.617.237AMBRISENTANLETAIRIS 9108Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA919.87.345PALIPERIDONEINVEGA 9109Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA9111.528.454LORAZEPAMATIVAN 9110Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81321.126VILOXAZINEQELBREE 9111Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA812.834.662AZALABRUTINIBCALQUENCE 9112Carrier G2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71126.743LINEZOLIDZYVOX 9113Carrier G2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA60.006908DEXCOM Receiver/Sensor/TransmiterDEXCOM Receiver/Sensor/Transmiter 9114Carrier G2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA30.005705SEMAGLUTIDEOZEMPIC 9115Carrier G2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.005203LISDEXAMFETAMINE DIMESYLATEVYVANSE 9116Carrier G2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA20.006903ADALIMUMABHUMIRA 9117Carrier G2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.004701TRETINOINRETIN-A 9118Carrier G2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA10.00503TERZEPATIDEMOUNJARO 9119Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64405Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve5048.6605NANA 9120Carrier K2024Inpatient 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 level50.821.5205NANA 9121Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT67900Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)4154.5504NANA 9122Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2370Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only30.666795.2302NANA 9123Carrier K2024Inpatient Med-SurgCodes 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 cm2154.5502NANA 9124Carrier K2024Inpatient 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 thereof2154.5502NANA 9125Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15773Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate2154.5502NANA 9126Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT15774Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof2154.5502NANA 9127Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21089Unlisted maxillofacial prosthetic procedure20.534.9502NANA 9128Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21139Reduction forehead; contouring and setback of anterior frontal sinus wall�2154.5502NANA 9129Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21175Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts2154.5502NANA 9130Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30117Excision or destruction (eg, laser), intranasal lesion; internal approach21143.302NANA 9131Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30140Submucous resection inferior turbinate, partial or complete, any method21143.302NANA 9132Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64484Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level2112.902NANA 9133Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCJ9039Injection, blinatumomab, 1 microgram2134.111NANA 9134Carrier K2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCK0108Wheelchair component or accessory, not otherwise specified20.5132.8502NANA 9135Carrier K2024Inpatient Med-SurgCodes 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 minutes20.5132.8502NANA 9136Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67900Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)4154.5504NANA 9137Carrier K2024Inpatient Med-SurgCodes 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 cm2154.5502NANA 9138Carrier K2024Inpatient Med-SurgCodes 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 thereof2154.5502NANA 9139Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15773Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate2154.5502NANA 9140Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15774Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof2154.5502NANA 9141Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21139Reduction forehead; contouring and setback of anterior frontal sinus wall�2154.5502NANA 9142Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT21175Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts2154.5502NANA 9143Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30117Excision or destruction (eg, laser), intranasal lesion; internal approach21143.302NANA 9144Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30140Submucous resection inferior turbinate, partial or complete, any method21143.302NANA 9145Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64484Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level2112.902NANA 9146Carrier K2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCJ9039Injection, blinatumomab, 1 microgram2134.111NANA 9147Carrier K2024Outpatient 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 21390.589732.96039NANA 9148Carrier K2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure250.817.18025NANA 9149Carrier K2024Outpatient 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 technologist230.608724.520.71122NANA 9150Carrier K2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64493�Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level190.84210.512.76118NANA 9151Carrier K2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30140Submucous resection inferior turbinate, partial or complete, any method120.7543.6012NANA 9152Carrier K2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30520Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft120.7546.44012NANA 9153Carrier K2024Outpatient 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 technologist120.536.81012NANA 9154Carrier K2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT17106Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm1110.69011NANA 9155Carrier K2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30465Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)100.454.68010NANA 9156Carrier K2024Outpatient Med-SurgCodes with the highest total number of 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 treated917.109NANA 9157Carrier K2024Outpatient Med-SurgCodes with the highest total number of 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 level90.666714.0209NANA 9158Carrier K2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT17106Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm1110.69011NANA 9159Carrier K2024Outpatient 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 treated917.109NANA 9160Carrier K2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT19318Breast reduction817.4508NANA 9161Carrier K2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52000Cystourethroscopy (separate procedure)710.7107NANA 9162Carrier K2024Outpatient 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 stent710.1907NANA 9163Carrier K2024Outpatient 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 C710.1407NANA 9164Carrier K2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT31255Nasal/sinus endoscopy, surgical with ethmoidectomy; total�6112.6506NANA 9165Carrier K2024Outpatient 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 leg6110.5206NANA 9166Carrier K2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49650Laparoscopy, surgical; repair initial inguinal hernia610.10.1615NANA 9167Carrier K2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT50590Lithotripsy, extracorporeal shock wave610.206NANA 9168Carrier K2024DMECodes 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)60.525.886NANA 9169Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0760Osteogenesis stimulator, low intensity ultrasound, non-invasive21162NANA 9170Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service1038.51NANA 9171Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0265Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, with mattress1042.50NANA 9172Carrier K2024DMECodes 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 adjustment1061.11NANA 9173Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver1038.51NANA 9174Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access1125.11NANA 9175Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5301Below knee, molded socket, shin, sach foot, endoskeletal system114.51NANA 9176Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL5968Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature114.51NANA 9177Carrier K2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCL8619Cochlear implant, external speech processor and controller, integrated system, replacement119.11NANA 9178Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogenesis stimulator, low intensity ultrasound, non-invasive21162NANA 9179Carrier K2024DMECodes 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 access1125.11NANA 9180Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5301Below knee, molded socket, shin, sach foot, endoskeletal system114.51NANA 9181Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL5968Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature114.51NANA 9182Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCL8619Cochlear implant, external speech processor and controller, integrated system, replacement119.11NANA 9183Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS1040Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)60.525.886NANA 9184Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4239Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service1038.51NANA 9185Carrier K2024DMECodes 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 rails, with mattress1042.50NANA 9186Carrier K2024DMECodes 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 adjustment1061.11NANA 9187Carrier K2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2103Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver1038.51NANA 9188Carrier K2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCA4239Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service1038.501NANA 9189Carrier K2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCE2103Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver1038.501NANA 9190Carrier K2024DMECodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealHCPCS1040Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)2043.5802NANA 9191Carrier K2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin311.23NANA 9192Carrier K2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin311.23NANA 9193Carrier L2024Inpatient 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 level190.842112.0327.71316NANA 9194Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64484Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)110.818223.24011NANA 9195Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64405Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve5025.0205NANA 9196Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT38525Biopsy or excision of lymph node(s); open, deep axillary node(s)40.750.3304NANA 9197Carrier L2024Inpatient 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)4132.2604NANA 9198Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT62323Injection(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, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)40.540.1504NANA 9199Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT21089Unlisted maxillofacial prosthetic procedure30.666717.303NANA 9200Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT31622Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)3121.103NANA 9201Carrier L2024Inpatient 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)30.33331303NANA 9202Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT64454Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed3023.2303NANA 9203Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT66991Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more31192.9603NANA 9204Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT97803Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes30.666737.0603NANA 9205Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT99183Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session311.503NANA 9206Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0277Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval311.503NANA 9207Carrier L2024Inpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearHCPCG0299Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes30.666784.503NANA 9208Carrier L2024Inpatient 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)4132.2604NANA 9209Carrier L2024Inpatient 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)3121.103NANA 9210Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT66991Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more31192.9603NANA 9211Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99183Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session311.503NANA 9212Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCG0277Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval311.503NANA 9213Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT15004Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children2120.902NANA 9214Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT30130Excision inferior turbinate, partial or complete, any method2122.5502NANA 9215Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT52235Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm)210.902NANA 9216Carrier L2024Inpatient Med-SurgCodes 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 approach2126.702NANA 9217Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT67950Canthoplasty (reconstruction of canthus)211802NANA 9218Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT76942Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation2143.902NANA 9219Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT95700Electroencephalogram (EEG) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by EEG technologist, minimum of 8 channels2113.202NANA 9220Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved 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 maintenance2113.202NANA 9221Carrier L2024Inpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT99152Moderate 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 older2122.902NANA 9222Carrier L2024Outpatient 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 technologist800.62521.180NANA 9223Carrier L2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT81479Unlisted molecular pathology procedure780.884614.5878NANA 9224Carrier L2024Outpatient 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 21730.780813.1573NANA 9225Carrier L2024Outpatient 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 technologist600.616715.960NANA 9226Carrier L2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30140Submucous resection inferior turbinate, partial or complete, any method340.911840.2434NANA 9227Carrier L2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT30520Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft310.93554231NANA 9228Carrier L2024Outpatient Med-SurgCodes with the highest total number of 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)3110.151.15427NANA 9229Carrier L2024Outpatient 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)290.689723.933.58425NANA 9230Carrier L2024Outpatient Med-SurgCodes with the highest total number of 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 level290.896612.0929NANA 9231Carrier L2024Outpatient Med-SurgCodes with the highest total number of prior authorization requests during the previous plan yearCPT58558Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D and C2610.22.48125NANA 9232Carrier L2024Outpatient 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)3110.151.15427NANA 9233Carrier L2024Outpatient 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 C2610.22.48125NANA 9234Carrier L2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT49650Laparoscopy, surgical; repair initial inguinal hernia2211.4622NANA 9235Carrier L2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT34675Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated20119.6720NANA 9236Carrier L2024Outpatient 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)1610.13.62214NANA 9237Carrier L2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT81229Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic hybridization (CGH) microarray analysis1314.9513NANA 9238Carrier L2024Outpatient 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 leg12119.1812NANA 9239Carrier L2024Outpatient 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 analysis12110.0212NANA 9240Carrier L2024Outpatient Med-SurgCodes with the highest percentage of approved prior authorization requests during the previous plan yearCPT64721Neuroplasty and/or transposition; median nerve at carpal tunnel1112.40.16110NANA 9241Carrier L2024Outpatient Med-SurgCodes 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)1110.4711NANA 9242Carrier L2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCA4239Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service170.529422.82017NANA 9243Carrier L2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2103Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver110.454513.15011NANA 9244Carrier L2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2402Negative pressure wound therapy electrical pump, stationary or portable60.666720.222.1215NANA 9245Carrier L2024DMECodes 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)5137.9805NANA 9246Carrier L2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other4047.5504NANA 9247Carrier L2024DMECodes with the highest total number of prior authorization requests during the previous plan yearHCPCE2510Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access415.0804NANA 9248Carrier L2024DMECodes 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 accessories319.9703NANA 9249Carrier L2024DMECodes 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 supply2062.8502NANA 9250Carrier L2024DMECodes 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)2062.8502NANA 9251Carrier L2024DMECodes 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 adjustment20.520.402NANA 9252Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCS1040Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)5137.9805NANA 9253Carrier L2024DMECodes 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 access415.0804NANA 9254Carrier L2024DMECodes 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 accessories319.9703NANA 9255Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0760Osteogenesis stimulator, low intensity ultrasound, non-invasive2114.8502NANA 9256Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE1399Durable medical equipment, miscellaneous2125.402NANA 9257Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2512Accessory for speech generating device, mounting system215.902NANA 9258Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE2599Accessory for speech generating device, not otherwise classified215.902NANA 9259Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA4238Supply allowance for adjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service116101NANA 9260Carrier L2024DMECodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCA7000Canister, disposable, used with suction pump, each117.301NANA 9261Carrier L2024DMECodes 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)1114.801NANA 9262Carrier L2024Diabetes Supplies and EquipCodes with the highest total number of prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin14112.1601NANA 9263Carrier L2024Diabetes Supplies and EquipCodes with the highest percentage of approved prior authorization requests during the previous plan yearHCPCE0784External ambulatory infusion pump, insulin14112.1601NANA 9264Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4310.7713450533780SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 0.25 MG/0.5MLWEGOVY 9265Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4300.6519390503800TIRZEPATIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 2.5 MG/0.5MLZEPBOUND 9266Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1720.4414440331390SEMAGLUTIDE SOLN PEN-INJ 0.25 OR 0.5 MG/DOSE (2 MG/3ML)OZEMPIC 9267Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1530.5913620421110RIMEGEPANT SULFATE TAB DISINT 75 MGNURTEC 9268Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1210.7432590191020SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 0.5 MG/0.5MLWEGOVY 9269Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1150.88039091060SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 2.4 MG/0.75MLWEGOVY 9270Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA910.711142012790SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 1 MG/0.5MLWEGOVY 9271Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA860.281256016700TIRZEPATIDE SOLN PEN-INJECTOR 2.5 MG/0.5MLMOUNJARO 9272Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA770.74120017600*CONTINUOUS GLUCOSE SYSTEM SENSOR***DEXCOM G7 SENSOR 9273Carrier K2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA690.75152109600RUXOLITINIB PHOSPHATE CREAM 1.5%OPZELURA 9274Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA141120950OFATUMUMAB SOLN AUTO-INJECTOR 20 MG/0.4MLKESIMPTA 9275Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA12101100120*INSULIN INFUSION DISPOSABLE PUMP RESERVOIR***OMNIPOD 5 DEXCOM G7G6 PODS (GEN 5) 9276Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA812100350OMALIZUMAB SUBCUTANEOUS SOLN PREFILLED SYRINGE 150 MG/MLXOLAIR 9277Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81000440BELIMUMAB SUBCUTANEOUS SOLUTION AUTO-INJECTOR 200 MG/MLBENLYSTA 9278Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA810180350RELUGOLIX-ESTRADIOL-NORETHINDRONE ACETATE TAB 40-1-0.5 MGMYFEMBREE 9279Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA810130080DROSPIRENONE TAB 4 MGSLYND 9280Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71010250METHYLPHENIDATE HCL CAP DELAYED ER 24HR 40 MG (PM)JORNAY PM 9281Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71000250METHYLPHENIDATE HCL CAP DELAYED ER 24HR 20 MG (PM)JORNAY PM 9282Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71000340TOFACITINIB CITRATE TAB ER 24HR 11 MG (BASE EQUIVALENT)XELJANZ XR 9283Carrier K2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA71100700LEUPROLIDE ACETATE INJ KIT 1 MG/0.2ML (5 MG/ML)LEUPROLIDE ACETATE 9284Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA510.1643.4467.68843n/aWEGOVY 9285Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA200.0621.8482.56119n/aZEPBOUND 9286Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA130.1245.6107.9310n/aDUPIXENT 9287Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA150.070134.64015n/aOZEMPIC 9288Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA120.127.36136.839n/aSKYRIZI PEN 9289Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA120.1144.438.16111n/aSTELARA 9290Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA100.1136.48182.8855n/aHUMIRA PEN 9291Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA90.040137.5209n/aMOUNJARO 9292Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA80.0782.5696.9617n/aNURTEC 9293Carrier K2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA70.0340.56268.843n/aREPATHA SURECLICK 9294Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA4060.1236620153910SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 0.25 MG/0.5MLWEGOVY 9295Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA3510.4914640522990SEMAGLUTIDE SOLN PEN-INJ 0.25 OR 0.5 MG/DOSE (2 MG/3ML)OZEMPIC 9296Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA2660.1641062600TIRZEPATIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 2.5 MG/0.5MLZEPBOUND 9297Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1680.3223500161520TIRZEPATIDE SOLN PEN-INJECTOR 2.5 MG/0.5MLMOUNJARO 9298Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1280.64768030980RIMEGEPANT SULFATE TAB DISINT 75 MGNURTEC 9299Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1150.761653034810SEMAGLUTIDE SOLN PEN-INJ 1 MG/DOSE (4 MG/3ML)OZEMPIC 9300Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA1000.58344024760*CONTINUOUS GLUCOSE SYSTEM SENSOR***DEXCOM G7 SENSOR 9301Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA770.75556012650SEMAGLUTIDE SOLN PEN-INJ 2 MG/DOSE (8 MG/3ML)OZEMPIC 9302Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA760.862421017590ADALIMUMAB PEN-INJECTOR KIT 40 MG/0.4MLHUMIRA PEN 9303Carrier L2024Prescription DrugsCodes with the highest total number of prior authorization requests during the previous plan yearGPI10NANA760.7272809670RISANKIZUMAB-RZAA SOLN AUTO-INJECTOR 150 MG/MLSKYRIZI PEN 9304Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA36115012240ADALIMUMAB AUTO-INJECTOR KIT 40 MG/0.4MLHUMIRA PEN 9305Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA1610001150LUBIPROSTONE CAP 24 MCGLUBIPROSTONE 9306Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA131010670DEXTROMETHORPHAN HBR-BUPROPION HCL TAB ER 45-105 MGAUVELITY 9307Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA101010280TOFACITINIB CITRATE TAB ER 24HR 11 MG (BASE EQUIVALENT)XELJANZ XR 9308Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81000260CALCIUM, MAG, POTASSIUM, & SOD OXYBATES ORAL SOLN 500 MG/MLXYWAV 9309Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA816130530MORPHINE SULFATE TAB ER 15 MGMORPHINE SULFATE ER 9310Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81010170DULAGLUTIDE SOLN PEN-INJECTOR 4.5 MG/0.5MLTRULICITY 9311Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA81100440SUVOREXANT TAB 10 MGBELSOMRA 9312Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA61110150DULAGLUTIDE SOLN PEN-INJECTOR 3 MG/0.5MLTRULICITY 9313Carrier L2024Prescription DrugsCodes with the highest percentage of approved prior authorization requests during the previous plan yearGPI10NANA61000060UPADACITINIB TAB ER 24HR 30 MGRINVOQ 9314Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA690.0229.7664.8564n/aWEGOVY 9315Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA170.147.04125.28314n/aOZEMPIC 9316Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA160.1142.9697.44610n/aSKYRIZI PEN 9317Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA15029.7662.4213n/aZEPBOUND 9318Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA130.0537.92179.28112n/aMOUNJARO 9319Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA130.1243.92167.7676n/aSTELARA 9320Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA90.0829.28143.7636n/aDUPIXENT 9321Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.0437.2131.2813n/aEntresto 9322Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.0238.457.3622n/aTaltz 9323Carrier L2024Prescription DrugsCodes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appealGPI10NANA40.0248.2418.2431n/aXolair