Document Library
Need a prior authorization form?
410 results found.
-
Artificial Intervertebral Discs 9364pdf|Surgical implantation of a cervical intervertebral disc requires prior authorization. (MP9364)
-
Lumbar Discography 9427pdf|Lumbar discography requires prior authorization and is considered medically necessary when a Neurosurgeon or Orthopedist requests as a decision making aid for surgery. (MP9427)