Does A39.84 require prior authorization?

No, A39.84 does not require prior authorization (high confidence). Covered without prior authorization.

`A39.84`, Postmeningococcal arthritis

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Claims for arthroscopic lavage/drainage for infection should be billed using CPT 29871 and reference NCD 150.9.
Policy cites NCD 150.9 and CMS Change Request 3281; any additional documentation or contractor-specific requirements are determined by the Medicare contractor.
Medical records must include history and physical notes, laboratory results, and documentation of signs and symptoms that warrant the head/neck diagnostic imaging.
Accurate HCPCS/CPT coding must be submitted to differentiate CT and MRI scans from other radiology services and to support coverage determinations.

All other indications for arthroscopic lavage of the knee are subject to Medicare contractor discretion.
Arthroscopic lavage and drainage of the knee for infection (septic arthritis) is covered and described by CPT 29871 per NCD 150.9.
CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
Total ankle arthroplasty (TAA) using a Food and Drug Administration-cleared implant medically necessary when the following criteria are met: TAA is used to replace an arthritic or severely degenerated ankle
Member is skeletally mature

AETNA-CPB-0645, Total Ankle Arthroplasty

A54061, Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knees

A57204, Billing and Coding: MRI and CT Scans of the Head and Neck

Ask Backwork about documentation requirements, denial risks, or coverage in your state.