Reason Code 5OP62: Item of Service Is Subject to Prior Authorization and No Prior Authorization Was Requested for the Item of Service

Published 07/23/2021

Reason Code 5OP62 indicates that a claim line has been denied because your item of service is subject to prior authorization and no prior authorization was requested for the item of service.

Reason for Denial
The claim was submitted without having an affirmed prior authorization for the service(s) billed.

How to Avoid This Denial

  • Submit a prior authorization for the service(s) billed, prior to rendering the service
  • Verify if the service(s) billed requires a prior authorization