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ICD-10-CM A02.25, Salmonella pyelonephritis | No Prior Auth

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`A02.25`, Salmonella pyelonephritis

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

Outpatient urine culture testing for bacteria is consideredmedically necessaryto evaluate any of the following situations:
Clinical signs or symptoms suggesting urinary tract infection (UTI);or
Abnormal urinalysis suggesting UTI;or
Asymptomatic bacteriuria in pregnant persons;or
Bacteriuria in individuals prior to undergoing an endoscopic urologic procedure;or
Suspected interstitial cystitis or bladder pain syndrome.

1 Active Policy

ANTHEM-CG-LAB-24, Outpatient Urine Culture

Related Codes

87088(1 policies)A02.1(1 policies)A18.11(1 policies)A18.14(1 policies)A40.0(1 policies)A41.9(1 policies)A42.7(1 policies)87086(1 policies)

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