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2019 Preauthorization Procedure Code Updates

The following preauthorization guidelines are applicable for Johns Hopkins Employer Health Programs (EHP), Priority Partners, and Johns Hopkins US Family Health Plan (USFHP) members.

Effective March 1, 2019, the following list of new procedure codes will require a preauthorization and must meet medical necessity.

For Johns Hopkins Employer Health Programs (EHP):

20932811638117781186812848133796113*96139*97158*V5181
76391811638117881187812858134396121*96146*A5514V5211
76981811658117981204812868134496130*97151*C8937V5212
76982811668118081233812898134596131*97152*E0447V5213
76983811678117181234813058144396132*97153*E0467V5214
77046811718118281237813068151896133*97154*G2011V5215
77047811728118381239813299227396136*97155*L8698V5221
77048811738118481271813339227496137*97156*V5171 
770498117481185812748133696112*96138*97157*V5172 

*Preauthorization requirements for these codes became effective January 1, 2019.

 

For Priority Partners:

2093277049811738118381237813058134596121**96139**V5181
7639181163811748118481239813068144396130**A5514 V5211
7698181164811778118581271813298151896131**C8937V5212
76982811658117881186812748133383722*96132**E0447V5213
7698381166811798118781284813369227396133**E0467V5214
7704681167811808120481285813379227496136**L8698V5215
77047811718118181233812868134396112**96137**V5171V5221
77048811728118281234812898134496113**96138**V5172 

*Note: Needs preauthorization only in POS 22.
**Preauthorization requirements for these codes became effective January 1, 2019.

 

For USFHP:

20932770469227396130*96137*97152*97157*L8698V5212
76391770479227496131*96138*97153*97158*V5171V5213
769817704896112*96132*96139*97154*A5514V5172V5214
769827704996113*96133*96146*97155*C8937V5181V5215
769838372296121*96136*97151*97156*L8608V5211V5221

*Preauthorization requirements for these codes became effective January 1, 2019.