Date Posted: 08/08/2025
The following codes were removed from our preauthorization list for the Site of Service program effective Aug. 1, 2025.
Codes Removed From Preauthorization List’s Site of Service Requirements Starting Aug. 1, 2025
| CPT/HCPCS Code | CPT Code Description |
|---|---|
19120 |
Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, one or more lesions |
19125 |
Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion |
19307 |
Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle |
44970 |
Appendectomy; for ruptured appendix with abscess or generalized peritonitis |