Free Tool

CPT & ICD-10 Code Lookup
with Prior Auth Flags

Search CPT and ICD-10 codes instantly. See which payers require prior authorization for each procedure, before you submit.

PA Key: Required Often Rarely No PA

52 codes found

Automate PA for Every Code

Greenlight checks PA requirements automatically for every order, assembles the documentation, and submits to the payer. No manual lookup needed.

See How It Works

Why CPT Code PA Flags Matter

Knowing whether a procedure requires prior authorization before you submit can save hours of rework and prevent costly denials.

Prevent Denials

Services performed without required prior authorization are frequently denied after the fact. Checking PA requirements before scheduling prevents these costly surprises.

Save Staff Time

Instead of calling each payer to ask “is PA required?”, your staff can check in seconds. That's time back for patient care and scheduling.

PA Varies by Payer

The same CPT code can require PA with one payer and not another. Our per-payer flags show you exactly who requires authorization for each procedure.

Code Lookup FAQs

How accurate are the PA flags?
Our PA flags reflect general requirements for each major payer's standard commercial plans. However, PA requirements can vary by specific plan, state, and member benefit design. Always verify with the payer for the specific member's plan. This tool gives you a strong starting point so you know what to expect.
What's the difference between "PA Required" and "PA Often Required"?
"PA Required" means the payer requires prior authorization for this code across nearly all plan types. "PA Often Required" means most plans require PA, but some plan variations (such as certain PPO or self-funded plans) may not. When in doubt, verify with the payer.
Why do some CPT codes show different PA requirements by payer?
Each insurance company sets its own utilization management policies. A procedure that UnitedHealthcare requires PA for might not require PA with Aetna, and vice versa. These policies are based on each payer's clinical guidelines, cost management strategies, and contracted network agreements.
What are common ICD-10/CPT pairings and why do they matter?
ICD-10/CPT pairings show which diagnosis codes are commonly submitted alongside a procedure code. Payers check these pairings to validate medical necessity. Using a diagnosis code that doesn't support the medical necessity of the procedure is a common reason for PA denials.
Do X-rays and ultrasounds require prior authorization?
In general, standard X-rays, screening mammograms, and basic ultrasounds do not require prior authorization from major commercial payers. Advanced imaging (MRI, CT with contrast, PET, nuclear studies) and specialized ultrasounds (echocardiography) are more likely to require PA.