Pre-service requests for unlisted procedure codes

Kaiser Permanente will review requests for authorization of unlisted or non-specific procedure codes.

Coverage determinations for these procedure codes will not reference billing requirements or limitations. The procedure code will always be subject to review when a claim is received, to validate that there is not a more appropriate billing code.

If you have questions regarding coverage or payment of unlisted procedure codes, please call Provider Assistance at 1-888-767-4670.

Requests for authorization of unlisted procedures should always include the following:

The procedure code.
A full description of the procedure or service.