Does A50.40 require prior authorization?

No, A50.40 does not require prior authorization (high confidence). Covered without prior authorization.

`A50.40`, Late congenital neurosyphilis, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.
Total the number of keratotic lesions debrided and select the most appropriate CPT code 11055-11057 based on that total (example: code 11056 for two to four lesions).

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
Psychiatric/psychological services are covered when there is a reasonable expectation that withdrawing treatment would cause the patient's condition to deteriorate, relapse, or require hospitalization.
CORF social and psychological services are covered when indicated and may be provided by qualified social workers (minimum BS) or psychologists (minimum Master’s level).
Psychiatric diagnostic procedures may be billed once per day and are covered at the outset of an illness or suspected illness, or again for a new episode after a hiatus or on (re)admission for complications of the underlying condition.
Psychotherapy codes that include an E/M component are payable when performed by physicians, physician assistants (PA), nurse practitioners (NP), or clinical nurse specialists (CNS) and the E/M component is documented in the record.
Interactive complexity add-on code 90785 may be reported in conjunction with specified diagnostic and psychotherapy codes when interactive complexity is present.

CGS-J15-L34353, Outpatient Psychiatry and Psychology Services

J15

CGS-J18-L34353, Outpatient Psychiatry and Psychology Services

J18

A56937, Billing and Coding: Psychiatry and Psychology Services

NGS-J6-L33632, Psychiatry and Psychology Services

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