New prior authorization requirement for cardiac procedures 92924 and C1605 effective Apr. 21, 2025

Effective Apr. 21, 2025, we’ll require prior authorization for the following cardiac procedures, for all lines of business:

• 92924: Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch
• C1605: Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation

These procedures will be managed by TurningPoint on behalf of our members. You’ll initiate your requests in prism’s Authorizations Request Tool and will be redirected automatically to TurningPoint’s provider portal to complete the request submission.