Does A49.9 require prior authorization?

No, A49.9 does not require prior authorization (high confidence). Covered without prior authorization.

`A49.9`, Bacterial infection, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

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.

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).
Exposure to hepatotoxins;or
Gastrointestinal disease;or

ANTHEM-CG-LAB-29, Gamma Glutamyl Transferase Testing

ANTHEM-CG-LAB-30, Outpatient Laboratory-based Blood Glucose Testing

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

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