Prior Approval Forms

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Aesthetic Surgery

• Abdominoplasty – Prior Approval Form
• Blepharoplasty – Prior Approval Form
• Breast-Augmentation-Non-Cancer-Related – Prior Approval Form
• Female Breast Reduction (Asymmetry) – Prior Approval Form
• Removal of Benign Skin Lesions – Prior Approval Form 
• Surgical Removal of Lipomata – Prior Approval Form

Ophthalmology

• Minor Eyelid Surgery – Prior Approval Form

Orthopaedics

• Carpal Tunnel Syndrome – Prior Approval Form
• Dupuytrens surgery – Prior Approval Form
• Ganglia – Prior Approval Application Form
• Surgical Foot Procedures – Prior Approval Form
• Trigger Finger – Prior Approval Form

Other

• Anal skin tags –Prior Approval –  
• Botulinum Toxin for Axillary Hyperhidrosis –Prior Approval Form
• Hernia Management and Repair in Adults – Prior Approval Form
• Ventral Mesh Rectopexy & Stapled Transanal Rectal Resection (STaRR) – Prior Approval Form