The updated Procedure Code Lookup (PCL) tool is even better equipped to help your office look up:
Procedure codes,
Benefit coverage, and
Individual patient history
With its easy-to-use self-service options, the PCL tool can help you answer questions more efficiently and effectively with these features at your fingertips:
Convenient access: The tool is located on our Patient Benefits Details page and can be accessed after you enter patient-specific information.
Comprehensive information: Upon entering a procedure code, the tool is designed to display the following categories of information:
Class of Service
Covered | Not Covered | Elective | COTC & Preauthorization Requirements | Age limitations (code and/or contractual)
Frequency limitations and usage
Treatment History and Related Treatment History returned for the dates within the procedure frequency time limitations.
Some instances may still require a call, including inquiries about DeltaCare and Flagship.