Does C1780 require prior authorization?

No, C1780 does not require prior authorization (high confidence). Covered without prior authorization.

`C1780`, Lens, intraocular (new technology)

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

Meeting vocational or recreational needs;or
Other daily activities;and
Cataract removal surgery in adults is consideredmedically necessaryforanyof the following:
The lens displays signs of cataract formation and the following criteria are met:The cataract is causing symptomatic impairment of visual function not correctable with a tolerable change in glasses or contact lenses;andVision loss interferes with one or more of the following:Reading;orViewing television;orDriving;orMeeting vocational or recreational needs;orOther daily activities;andOther eye disease(s) have been ruled out as the primary cause of decreased visual function including, but not limi [...]
The cataract is causing symptomatic impairment of visual function not correctable with a tolerable change in glasses or contact lenses;and
Vision loss interferes with one or more of the following:Reading;orViewing television;orDriving;orMeeting vocational or recreational needs;orOther daily activities;and

ANTHEM-CG-SURG-40, Cataract Removal Surgery for Adults

ANTHEM-CG-SURG-77, Refractive Surgery

BCBSIL-SUR713.025, Intraocular Lens (IOLs) and Implantable Miniature Telescope (IMT)

BCBSMT-SUR713.025, Intraocular Lens (IOLs) and Implantable Miniature Telescope (IMT)

BCBSNM-SUR713.025, Intraocular Lens (IOLs) and Implantable Miniature Telescope (IMT)

Ask Backwork about documentation requirements, denial risks, or coverage in your state.