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2022-06: Medicare Prior Authorization Requirement Update

Date: 11/15/22

Wellcare by Allwell requires prior authorization (PA) as a condition of payment for many services. This Notice contains information regarding such prior authorization requirements and is applicable to all Medicare products offered by Wellcare by Allwell.

Wellcare by Allwell is committed to delivering cost-effective quality care to our members. This effort requires us to ensure that our members receive only treatment that is medically necessary according to current standards of practice. Prior authorization is a process initiated by the physician in which we verify the medical necessity of treatment in advance using independent objective medical criteria and/or in-network utilization, where applicable.

It is the ordering/prescribing provider’s responsibility to determine which specific codes require prior authorization.

Please verify eligibility and benefits before rendering services for all members. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered. NON-PAR PROVIDERS & FACILITIES REQUIRE AUTHORIZATION FOR ALL HMO SERVICES EXCEPT WHERE INDICATED.       

For complete CPT/HCPCS code listing, please see the Online Prior Authorization Tool at www.louisianahealthconnect.com.    

Effective January 1st, 2023, the following are changes to prior authorization requirements

Service Category

 

PA Rule

Services

Procedure Codes

Anesthesia

No PA Required

Anesthesia for nerve blocks

01991, 01992

Audiology

PA Required

Hearing aid

V5256, V5258, V5261

No PA Required

Speech audiometry threshold

0210T

Behavioral Health

PA Required

Behavior assessments

97151, 97152

Adaptive behavior treatment

97153, 97154, 97155, 97156

No PA Required

 

Psychotherapy, training & education

90832, 90834, 90837, 90846, 90847, 90853, G0177

Hypnotherapy

90880

Brief behavior assessment

96127

Breast reconstruction

PA Required except with breast cancer diagnosis

Breast reconstruction

19367, 19368, 19369

Cardiovascular

PA Required

Artificial heart

33927

Pulmonary artery pressure sensor

C2624

Unlisted procedures

37501

No PA Required

Operative ablation

33261

Exclusion left atrial appendage

33267, 33268, 33269

Artificial heart removal/replacement

33928, 33929

Extracorporeal membrane oxygenation (ECMO)

33953, 33954, 33955, 33956, 33957, 33958, 33959

External circulatory support

92971, G0166

Carotid intima media thickness study

93895

Carotid sinus baroreflex activation device

0269T

Devices and monitoring

0497T, 0498T, 0650T

Blinded procedure for NYHA Class III/IV heart failure

C9758

Cochlear and other auditory implants

PA Required

Auditory implant and device

L8619, L8690, L8691

No PA Required

Replacement Headset/headpiece

L8615

Cosmetic and reconstructive

PA Required

Lipectomy

15876, 15878

Reconstruction head/face

21175, 21179, 21180, 21181, 21182, 21183, 21184, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21275

Excision or surgical planing for rhinophyma

30120

No PA Required

Reduction forehead

21137, 21138, 21139

Otoplasty

69300

Dental

No PA Required

Application of topical fluoride varnish

99188

 Dermatology

PA Required

Chemodenervation of eccrine glands

64650, 64653

No PA Required

Autografts

15131, 15135, 15136, 15150, 15152, 15155, 15156, 15157

Laser treatments

17106, 0491T, 0492T

Cryotherapy

17340

Incision and drainage, deep abscess

22010, 22015

Cell therapy for scleroderma 

0489T, 0490T

Autologous platelet rich plasma

G0465

Diagnostic imaging

PA Required

Magnetic resonance image guided high intensity focused ultrasound

0398T

No PA Required

Ablation, cryosurgical, of fibroadenoma

19105

Discography

72285, 72295

Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac)

76979

Fluoroscopic guidance

77002, 77003

Unlisted imaging procedures

78199, 78399, 75899, 78799

Salivary gland imaging and function study

78230, 78231, 78232

Gastrointestinal system imaging

78261, 78282, 78299

Nervous system imaging

78610, 78635, 78660, 78699

CAD for lesion detection

0174T, 0175T

Myocardial imaging

0331T, 0332T

Radiostereometric analysis (RSA)

0348T, 0349T, 0350T

Optical coherence tomography (OCT)

0351T, 0352T, 0353T, 0354T, 0443T, 0485T, 0486T, 0606T

Biomechanical mapping

0487T

Spectroscopy studies

0493T, 0641T, 0642T, 0658T

Cardiac magnetic resonance imaging for morphology and function

C9762, C9763

Set-up portable x-ray equipment

Q0092

DME & Supplies

PA Required

Walker, heavy-duty

E0147

Hospital beds and accessories

E0181, E0184, E0185, E0186, E0193, E0196, E0197, E0199, E0250, E0251, E0255, E0256, E0260, E0261, E0271, E0272, E0277, E0280, E0293, E0294, E0295, E0301, E0303, E0304, E0305, E0310, E0329, E0371, E0373

Respiratory devices

E0434, E0439, E0445, E0465, E0466, E0470, E0471, E0482, E0483, E0486, E1390, E1399

Patient lifts

E0630, E0635, E0636, E0640

Pneumatic compressor devices

E0650, E0651, E0652, E0656, E0660, E0667, E0668, E0671, E0673, E0675, E0676

Nerve stimulators

E0720, E0730, E0731, E0740, E0745, E0747, E0748, E0760, E0766

Diabetic devices & supplies

E0784, K0554

Continuous passive motion device

E0935

Wheelchairs, power operated vehicles, and accessories

E0953, E0954, E0956, E0957, E0973, E0981, E0982, E0990, E1002, E1007, E1008, E1010, E1016, E1028, E1031, E1035, E1038, E1050, E1060, E1088, E1150, E1161, E1195, E1226, E1230, E1236, E1238, E1240, E2209, E2210, E2228, E2300, E2310, E2312, E2313, E2322, E2325, E2330, E2331, E2359, E2361, E2363, E2365, E2366, E2367, E2370, E2373, E2374, E2375, E2376, E2377, E2378, E2381, E2382, E2383, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, E2397, E2603, E2604, E2605, E2606, E2607, E2608, E2609, E2613, E2615, E2616, E2617, E2620, E2621, E2622, E2623, E2624, E2626, E2627, K0003, K0004, K0005, K0006, K0007, K0010, K0017, K0018, K0019, K0037, K0042, K0043, K0044, K0045, K0047, K0051, K0052, K0053, K0069, K0070, K0071, K0072, K0077, K0108, K0195, K0733, K0739, K0800, K0801, K0806, K0808, K0813, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0835, K0836, K0837, K0838, K0839, K0841, K0842, K0843, K0848, K0849, K0856, K0857, K0858, K0859, K0861, K0862, K0863

Upper & lower limb bracing devices

E1800, E1801, E1805, E1810, E1811, E1815, E1825

Speech generating device/accessory

E2508, E2510, E2512

No PA Required

Skin protection supplies

E0188, E0190, E0191, A4640

Pump or water circulating pad

E0236

Respiratory equipment

E0550, E0555, E0560, E0565, E0600, E0615, E0621, E0700, E0781, E0791, K0730

Traction equipment, trapeze bars, extremity belt/harness

E0849, E0855, E0870, E0910, E0911, E0912, E0940, E0945

Wheelchairs and accessories

E0950, E0951, E0952, E0955, E0960, E0978, E0995, E1020, E2202, E2203, E2204, E2311, E2321, E2323, E2326, E2342, E2601, E2602, E2611, E2612, E2619, K0002, K0038, K0039, K0040, K0041, K0056, K0073

Infusion pumps and supplies

A4220, A4222, A4602, B9004, K0455, K0552, K0553, K0603

Helmet

A8003

Miscellaneous DME supplies

A4465, A5102, A7048, A9999

Surgical supplies

C1761, C1823, L8612, L8684

Endocrinology

PA Required

Unlisted laparoscopy procedure

60659

No PA Required

Ambulatory continuous glucose monitoring

95250

Creation of subcutaneous pocket/removal implantable interstitial glucose sensor

0446T, 0447T, 0448T

Enteral & Parenteral nutrition

PA Required

In-line cartridge digestive enzyme

B4105

No PA Required

Nutrition

B4103, B4104, B4149, B4150, B4152, B4153, B4154, B4155, B4160, B4161, B4185

Home therapy

S9340, S9341, S9342, S9343

Gastroenterology

PA Required

Unlisted laparoscopy, spleen

38129

Transoral lower esophageal myotomy

43497

No PA Required

Esophagogastroduodenoscopy

43235, 43236, 43237, 43238, 43239, 43240, 43241, 43242, 43245, 43247, 43248, 43249, 43250, 43251, 43253, 43254, 43255, 43259

Gastric/gastrointestinal systems surgery/procedures

43651, 43652, 43882, 44139, 44899, 45499, 47570, 0184T

General surgery

No PA Required

Hernia repair 

49495, 49496, 49505, 49525, 49550, 49570, 49585, 49650, 49651

Adrenalectomy

60545

Genetic counseling

No PA Required

Genetic counseling services

96040

Gynecology

No PA Required

Vulvectomy

56632, 56637, 56640

Stress incontinence treatment, revision/removal of vaginal graft

57288, 57289, 57296

Hysteroscopy

58558, 58565, 58579

Laparoscopy

58672, 58673, 58674, 58679

Resection initial/tumor debulking

58950, 58958

Hysterectomy after cesarean

59525

Uterine fibroids(s) ablation

0404T

Home care

No PA Required

Home visit

99501, 99502, 99503, 99505, 99506, 99507, 99511

Infertility

PA Required

Artificial insemination

58321, 58322, 58323, 58345

Embryo transfer

58970, 58974, 58976

Infusion services

No PA Required

Infusion and home infusion therapy

96371, 96422, 96425, 96440, 96549

S9346, S9348, S9364, S9366, S9367, S9494, S9500

Injectable medications

Step therapy

Injectables

J2777, J3299, Q2056, Q5124, Q5125

PA Required

Injectables

C9047, J0135, J0180, J0221, J0565, J0596, J0630, J0725, J0745, J1170, J1290, J1322, J1560, J1600, J1620, J1726, J1729, J1744, J1750, J1756, J1830, J2358, J2440, J2502, J2504, J3060, J3355, J7175, J7179, J7189, J7196, J7201, J7209, Q0138, Q0139, Q0221, Q2026

No PA Required

Injectables

 

0481T, C9257, C9290, J0122, J0130, J0200, J0205, J0210, J0215, J0288, J0289, J0300, J0348, J0380, J0390, J0395, J0401, J0470, J0475, J0480, J0485, J0520, J0583, J0600, J0620, J0637, J0714, J0740, J0742, J0770, J0834, J0841, J0875, J0878, J0887, J0895, J1071, J1162, J1180, J1201, J1250, J1265, J1270, J1320, J1325, J1327, J1436, J1440, J1451, J1452, J1571, J1573, J1640, J1645, J1652, J1655, J1730, J1738, J1833, J1835, J1890, J1945, J1950, J1960, J1990, J2248, J2260, J2265, J2270, J2274, J2278, J2315, J2320, J2407, J2425, J2426, J2513, J2547, J2670, J2724, J2725, J2730, J2770, J2788, J2792, J2810, J2910, J2916, J2995, J3070, J3090, J3095, J3145, J3265, J3280, J3320, J3350, J3364, J3365, J3400, J7168, J7316, Q5105, S0020, S0028, S0030, S0032, S0073, S0077, S0078, S0164, S0171

Laboratory

PA Required

DMD (Dystrophin)

81161

Multianalyte assay tests

0014M, 0017M

Proprietary Laboratory Analysis (PLA) Codes

0002U, 0003U, 0027U, 0037U, 0040U, 0062U, 0063U, 0092U, 0093U, 0105U, 0108U, 0112U, 0117U, 0163U, 0169U, 0170U, 0171U, 0174U, 0177U, 0180U, 0181U, 0182U, 0183U, 0184U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0242U, 0243U, 0244U, 0245U, 0246U, 0247U, 0250U, 0254U, 0329U

Quantitative drug testing

G0481, G0482, G0483

No PA Required

Drug tests

80184, 80368, 83992, G0480, G0659

Unlisted lab procedures

81099, 85999, 86849, 87999, 88099, 88749, 89240

Human leukocyte antigen (HLA) Typing

81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81383, 86812, 86813, 86816, 86817, 86825, 86826 86828, 86829, 86830, 86831, 86832, 86833, 86834, 86835

Genetic and multianalyte assay tests

81341, 81420, 81506, 81507, 82784, 87483, 88239,  

Proprietary Laboratory Analysis (PLA) Codes

0140U, 0141U, 0142U, 0152U, 0206U, 0207U, 0210U, 0226U, 0251U, 0323U, 0330U, 0500T

Medication

PA Required

Buprenorphine/naloxone

J0574

Dexamethasone, ophthalmic insert

J1096

Ganciclovir 4.5 mg long-acting implant

J7310

Lymphocyte immune globulin

J7511

Treprostinil inhalation solution

J7686

Iloprost inhalation solution

Q4074

Dextroamphetamine sulfate 5mg

S0160

No PA Required

Bupivacaine collagen-matrix implant 1 mg

C9089

Cinacalcet oral 1mg for (ESRD on dialysis)

J0604

Phenylephrine & Ketorolac Ophthalmic

J1097

Insulin for administration through DME

J1817

Topical for actinic keratosis

J7308, J7309

Capsaicin patch

J7335, J7336

Parenteral solutions

J7501, J7503, J7505, J7508, J7516, J7518, J7520, J7525, J7599

Inhalation solutions

J2062, J7604, J7622, J7624, J7627, J7628, J7629, J7632, J7633, J7634, J7635, J7636, J7640, J7641, J7647, J7648, J7649, J7650, J7658, J7659, J7660, J7667, J7668, J7669, J7670, J7680, J7681, J7683, J7684, J7685, J7699

Non-inhalation drug for DME

J7799

Unlisted chemo drug

J7999

Antiemetics

J8498, J8597, Q0167, Q0174, S0183

Leuprolide acetate per 1mg

J9218

Drug or biological, part b drug competitive acquisition program (CAP)

Q4082

Drugs for opioid use disorder

S0106, S0109

Calcitrol

S0169

Neonatal care

PA Required

Unlisted fetal invasive procedure

59897

No PA Required

Initiation of hypothermia in neonate

99184

Neurology

PA Required

Creation of lesion by stereotactic method

61790, 61791

No PA Required

Graft for facial nerve paralysis

15840, 15841, 15842, 15845

Injection for myelogram/CT

62284, 62294

Removal of implanted catheter

62355

Quantitative sensory testing (QST)

0106T, 0107T, 0108T, 0109T, 0110T

Neurostimulators

PA Required

Insertion/replacement neurostimulator

0425T, 0426T

No PA Required

Electronic analysis of neurostimulator

95970, 95971, 95972, 95980, 95981, 95982

Removal of neurostimulators system

0428T

Nutritional counseling

No PA Required

Nutritional counseling, dietitian visit

S9470

Ophthalmology

PA Required

Prosthetic eye, scleral cover shell

V2623, V2627, V2629

No PA Required

Keratoplasty, keratoprosthesis

65730, 65750, 65755, 65756, 65757, 65770

Glaucoma treatments

65855, 66170, 66172, 66183

Cataract procedures

66820, 66821, 66825, 66830, 66840, 66850, 66852, 66940, 66982, 66983, 66984, 66985, 66986, 66987, 66988, 66989, 66991

Treatment of extensive/progressive retinopathy, scleral reinforcement

67228, 67255

Unlisted ophthalmology procedure

67399, 92499

Orbitotomy without bone flap

67405

Canthotomy

67715

Eyelid procedures

67912, 67938, 67961, 67966, 67999

Conjunctiva procedures

68325, 68340, 68360, 68371, 68399

Lacrimal procedures

68761, 68899

Retinal prosthesis

0100T

Ocular monitoring and screening

0198T, 0329T, 0330T, 0333T, 0378T, 0379T

Scleral lenses

V2531

Orthopedic

PA Required

Computer-assisted surgical navigation

0054T, 0055T

No PA Required

Procedures upper extremities

23450, 23462, 23465, 23490, 24346, 25240, 25449, 25830, 26497, 26530, 26531, 26535, 26536

Open treatment of iliac spine(s)

27215

Procedures lower extremities

27330, 27455, 27457, 27538, 27540, 27830, 28302, 28302, 28510, 28705, 28715, 28725, 28730, 28735, 28737, 28740

Arthroscopy

29800, 29830, 29835, 29847, 29900, 29902, 29904, 29905, 29906

Device placement for radiostereometric analysis

0347T

SI Joint injection

G0259

Orthotics and Prosthetics

PA Required

Prosthesis (penile)

C1813, C2622

Spinal orthotics

 

L0456, L0457, L0462, L0464, L0482, L0486, L0491, L0631, L0636, L0637, L0648, L0650, L0999, L1005, L1499

Lower extremity orthotics

L1685, L1686, L1832, L1833, L1834, L1843, L1844, L1845, L1846, L1907, L1932, L1940, L1945, L1950, L1951, L1960, L1970, L1971, L1990, L2020, L2036, L2037, L2108, L2250, L2280, L2330, L2340, L2350, L2510, L2520, L2861, L2999, L3030, L3230, L3730, L3763, L3901, L3999, L4631

Lower extremity prosthetics

L5000, L5020, L5050, L5100, L5210, L5220, L5301, L5312, L5321, L5331, L5530, L5540, L5580, L5590, L5611, L5617, L5626, L5631, L5643, L5645, L5646, L5647, L5648, L5649, L5650, L5651, L5652, L5653, L5665, L5671, L5673, L5677, L5679, L5681, L5683, L5700, L5701, L5703, L5704, L5705, L5706, L5707, L5781, L5782, L5785, L5790, L5811, L5812, L5814, L5816, L5822, L5828, L5840, L5845, L5848, L5856, L5857, L5920, L5940, L5950, L5960, L5961, L5962, L5964, L5968, L5973, L5975, L5976, L5979, L5980, L5981, L5984, L5986, L5987, L5988, L5999

Upper extremity prosthetics

 

L6055, L6100, L6110, L6120, L6500, L6550, L6621, L6624, L6686, L6687, L6689, L6693, L6694, L6695, L6696, L6698, L6708, L6709, L6721, L6722, L6880, L6881, L6882, L6884, L6935, L6955, L7007, L7009, L7040, L7180,

L7404, L7499, L8699, L8701, L9900

No PA Required

Impression and prosthetic preparation

21076, 21079, 21080, 21081, 21082, 21083, 21085

Cervical collar

L0200

Orthotics

L0460, L0635, L1848, L2112, L2114, L2116, L3760, L3905, L3915, L3916, L3960, L4205, L5450, L5460

Battery charger(s)

L7366, L7368

Custom breast prosthesis

L8035

Artificial larynx

L8500

Ocular implant

L8610, L8670

Osteopathy

No PA Required

Osteopathic manipulative treatment

98925, 98926, 98927, 98928, 98929

Otolaryngology

No PA Required

Surgical procedures of nasal/sinus and ears

31050, 31051, 31075, 31080, 31081, 31084, 31086, 31087, 31090, 31201, 31290, 31291, 31294, 31611, 69717, 69979

Pain management

PA Required

Injection, anesthetic agent or steroid

64400, 64408, 64415, 64416, 64417, 64418, 64420, 64421, 64430, 64445, 64446, 64447, 64448, 64449, 64454, 64480, 64484, 64491, 64492, 64494, 64495

Implant of hypoglossal neurostimulator

64582

Destruction by neurolytic agent

64634, 64636, 64640

No PA Required

Injection, anesthetic agent

64505, 64517, 64530

Destruction by neurolytic agent

64620, 64630, 64632, 64680, 64681

Preventive

No PA Required

Unlisted preventative medicine service

99429, 0358T

Preventive behavior change program

0403T, 0488T

Professional services

No PA Required

Physician or other qualified health care professional supervision

99380, G0068, G0128, G2082, G0039

Pulmonology

PA Required

Drug Induced Sleep Endoscopy (DISE)

42975

No PA Required

Bronchoscopy

C9751

Skin substitute

PA Required

Skin substitute products

Q4107, Q4108, Q4114, Q4123, Q4127, Q4130, Q4140, Q4141,

Q4142, Q4143, Q4146, Q4147,

Q4149, Q4150, Q4152, Q4156,

Q4157, Q4164, Q4173, Q4175,

Q4184, Q4185, Q4188, Q4189,

Q4190, Q4191, Q4192, Q4193, Q4194, Q4198, Q4200, Q4201, Q4202, Q4203, Q4204, Q4249, Q4250, Q4254, Q4255, Q4112, Q4113

No PA Required

Dermal and epidermal substitute

J7340

Therapy service

PA Required

Activity therapy

G0176

No PA Required

Extracorporeal shock wave

0101T, 0102T

Transplant services

No PA Required

Surgical preparation

0494T, 0495T, 0496T

Transportation

No PA Required

Ambulance services

A0426, A0428, A0431, A0436, A0999

Unlisted misc. procedures

PA Required

Unlisted procedure mediastinum, diaphragm, mouth

39499, 39599, 40899

No PA Required

Unlisted procedure, immunology

95199

Urology

PA Required

Unlisted laparoscopy, renal

50549

No PA Required

 

Lithotripsy, extracorporeal shock wave

50590

Closure of vesicouterine fistula

51925

Cystourethroscopy

52005, 52007, 52204, 52224, 52234, 52235, 52240, 52276, 52287, 52300, 52320, 52325, 52330, 52332, 52341, 52344, 52351, 52352, 52353, 52354, 52356, 52402, C9740, C9761, C9769

Insertion of tandem cuff

53444

Transurethral radiofrequency micro-remodeling of female bladder neck and proximal

53860

Destruction of penial lesion(s)

54060

Unlisted laparoscopy, testis

54699

Biopsy, prostate; needle or punch

55700

Vaccines

No PA Required

Immunizations/administration

SARS-CoV-2

90376, 90620, 91311, 0112A