Prior authorization update for select DME items

Effective January 1, 2024, the following durable medical equipment (DME) codes will require prior authorization (PA):

• L4631
• L0810
• E8001
• E8002
• K0006
• L1200
• L1300
• L2128
• L2627
• L5010
• L5020
• L5535
• L5540
• L5580
• L5610
• L5611
• L5614
• L5643
• L5681
• L5683
• L5822
• L5930

What is the impact of this change? 

Providers should review the list of codes that will require PA. For code-specific PA requirements, visit https://providers.anthem.com/ohio-provider/home

How do I obtain precertification? 

PA requests can be submitted through Availity Essentials* at https://tinyurl.com/y9s7wd79 by calling Provider Services at 844-912-1226, or by fax at 877-643-0672.

If you have questions about this communication or need assistance with any other item, contact your local Provider Relationship Management representative or call Provider Services at 844-912-1226.

We are committed to a future of shared success.