Notification of Revised Preauthorization Requirements by Code
Effective July 1, 2022, the following codes will be removed from the Preauthorization Requirements Code List:
Code |
Description |
| 81405 | MOLECULAR PATHOLOGY PROCEDURE LEVEL 6 |
| 81406 | MOLECULAR PATHOLOGY PROCEDURE LEVEL 7 |
| 81408 | MOLECULAR PATHOLOGY PROCEDURE LEVEL 9 |
| 15820 | Blepharoplasty, lower eyelid |
| 15821 | Blepharoplasty, lower eyelid; with extensive herniated fat pad |
| 67901 | Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) |
| 67902 | Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) |
| 67903 | Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach |
| 67904 | Repair of blepharoptosis; (tarso) levator resection or advancement, external approach |
| 67906 | Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) |
| 67908 | Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) |
Codes requiring preauthorization are maintained in the Preauthorization Requirements Code List. This list can be located under "Documents, Resources, and Bulletins" on the Provider page of the Vibra Health Plan web portal.