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ICD-10-CM A28.9, Zoonotic bacterial disease, unspecified | No Prior Auth

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`A28.9`, Zoonotic bacterial disease, unspecified

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

The CPB references clinical assessment methods used in studies (e.g., clinical signs and symptoms [CSS], NERDS/STONEES/UPPER/LOWER checklists, microbiological swabs, biopsies) but does not mandate these as documentation requirements for coverage.
The CPB does not specify formal documentation requirements or required medical-record elements for coverage determination.

Key Coverage Criteria

MolecuLight, a hand-held device, for point-of-care fluorescence imaging of wounds
Noncontact, nonthermal, low-frequency ultrasound therapy for the treatment of wounds and all other indications (e.g., bacterial infections, deep tissue pressure injury, and femoral artery thrombosis)
Warm-Up Active Wound Therapy, also known as noncontact normothermic wound therapy (NNWT) and warming therapy
None — The CPB states the following are considered experimental and investigational because effectiveness has not been established: MolecuLight (hand-held device) for point-of-care fluorescence imaging of wounds; noncontact, nonthermal, low-frequency ultrasound therapy for the treatment of wounds and all other indications; Warm-Up Active Wound Therapy (noncontact normothermic wound therapy / NNWT / warming therapy).

1 Active Policy

AETNA-CPB-0372, Wound Imaging and Noninvasive Wound Therapy

Related Codes

A00.0(1 policies)A09(1 policies)A20.0(1 policies)A30.0(1 policies)A49.9(1 policies)A6000(1 policies)E0231(1 policies)97610(1 policies)

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