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Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

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Ambetter PA Change Notification

Date: 07/28/21

These codes are being added to the Ambetter from MHS prior authorization list as part of standard reviews of our prior authorization (PA) lists to ensure our members are receiving medically necessary, appropriate care.

Procedure Code

Procedure Description

54401

Insertion of penile prosthesis; inflatable (self-contained)

54405

Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir

61885

Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array

61886

Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays

64568

Incision for implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator

69714

Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy

77371

Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based