procedure code 78816 — prior authorization under Kaiser Permanente
Billing code 78816 · Category: imaging
In our reference, this procedure typically requires prior authorization.
Typical turnaround is 7 day(s); Kaiser Permanente's
standard turnaround is 5 business days (72 hours if urgent).
How to submit
Internal Kaiser referral system
Documentation typically required
Biopsy/pathology report
CT/MRI results
Oncology referral
Common reasons this gets denied
Staging not indicated
CT/MRI sufficient
Kaiser Permanente-specific notes
Integrated model — most in-network services skip PA
Out-of-network referrals require PA
Specialty referrals via PCP gateway
Coverage limits: this page does not confirm authorization for any specific member's plan, and does not cover state-specific plan variants, out-of-network requests, or every payer x procedure pair in existence. For a definitive answer, contact Kaiser Permanente directly using the submission method above.
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