Peridex Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

California - Uniform Prior Authorization FormCalifornia
Colorado - Uniform Prior Authorization FormColorado
Illinois - Uniform Prior Authorization FormIllinois
Indiana - Uniform Prior Authorization FormIndiana
Louisiana - Uniform Prior Authorization FormLouisiana
Minnesota - Uniform Prior Authorization FormMinnesota

ICD-10 codes for Peridex Prior Authorizations

K05.10Acute gingivitis, plaque induced
K05.11Acute gingivitis, non-plaque induced
K05.00Chronic gingivitis, plaque induced
K05.01Chronic gingivitis, non-plaque induced

Support for Getting Your Patient on Peridex

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