Preauthorization Requirement Changes Starting April 1, 2024

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Preauthorization Requirement Changes Starting April 1, 2024

Date Posted: 04/10/2024

The following new codes were added to our preauthorization list starting April 1, 2024.

Codes Added to Preauthorization List Starting April 1, 2024

CPT/HCPCS Code CPT Code Description

0444U

Oncology (solid organ neoplasia), targeted genomic sequence analysis panel of 361 genes, interrogation for gene fusions, translocations, or other rearrangements, using DNA from formalin-fixed paraffin-embedded (FFPE) tumor tissue, report of clinically significant variant(s)

0448U

Oncology (lung and colon cancer), DNA, qualitative, next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes, formalin-fixed paraffin-embedded (FFPE) solid tumor samples, reported as presence or absence of targeted mutation(s), with recommended therapeutic options

A4271

Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per month

E0468

Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions

E2104

Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge

E2298

Complex rehabilitative power wheelchair accessory, power seat elevation system, any type

K1037

Docking station for use with oral device/appliance used to reduce upper airway collapsibility

L1320

Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated

L5783

Addition to lower extremity, user adjustable, mechanical, residual limb volume management system

L5841

Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control

 

The following code is deleted starting April 1, 2024.

Code Removed From Preauthorization List Starting April 1, 2024

CPT/HCPCS Code CPT Code Description

E2300

Wheelchair accessory, power seat elevation system, any type

The following code description was revised starting April 1, 2024.

Code With Description Updated in Preauthorization List Starting April 1, 2024

CPT/HCPCS Code CPT Code Description

E2001

New description: Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system

Old description: Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system

 

JP 56610 4/24