![]() Arthroscopy, shoulder, surgical debridement, limited, 1 or 2 discrete structuresĪrthroscopy, shoulder, surgical debridement, extensive. Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint with implantĬorrection, hallux valgus (bunionectomy), with sesamoidectomy, when performed with resection of proximal phalanx base, when performed, any methodīunionectomy with proximal metatarsal osteotomyĬorrection, hallux valgus (bunionectomy), with sesamoidectomy, when performed with distal metatarsal osteotomy, any methodĬorrection, hallux valgus (bunionectomy), with sesamoidectomy, when performed with first metatarsal and medial cuneiform joint arthrodesis, any methodĬorrection, hallux valgus (bunionectomy), with sesamoidectomy, when performed with proximal phalanx osteotomy, any methodĬorrection, hallux valgus (bunionectomy), with sesamoidectomy, when performed with double osteotomy, any methodĪrthroscopy, shoulder, diagnostic with or without synovial biopsyĪrthroscopy, shoulder, surgical capsulorrhaphyĪrthroscopy, shoulder, surgical repair of SLAP lesionĪrthroscopy, shoulder, surgical with removal of loose body or foreign bodyĪrthroscopy, shoulder, surgical synovectomy, partialĪrthroscopy, shoulder, surgical synovectomy, completeĪrthroscopy, shoulder, surgical debridement, limited. Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint without implant Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative sessionĬodes Being Removed from Preauthorization ListĬorrection, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy) Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir Insertion of penile prosthesis inflatable (self-contained) Sipuleucel-T, minimum of 50 million autologous cd54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed See full CPT Codes and their descriptions in the following table: These new codes supplement the ones that already require preauthorization for Neurostimulators, Potentially Unproven Services, and Cosmetic & Reconstructive Surgery. 1, 2022, five new CPT codes will require preauthorization. This is part of an ongoing evaluation of our preauthorization lists and an effort to simplify the administrative burden for our providers. 1, 2022, we are removing 99 codes from ConnectiCare’s Preauthorization Requirements for Commercial and Medicare plans.
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