Does B02.23 require prior authorization?

No, B02.23 does not require prior authorization (medium confidence). Covered without prior authorization by at least one policy, though another does not cover it.

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`B02.23`, Postherpetic polyneuropathy

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Documentation Required

All documentation must be maintained in the patient's medical record, be legible, include patient identifiers and dates of service, and be made available to the contractor upon request.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for the care and the submitted records must support the selected ICD-10-CM and CPT/HCPCS codes.
Procedural reports for SNRBs and TFESIs must document indications, medical necessity, and baseline pain score; SNRBs must also document percent pain relief achieved immediately after the injection.
Fluoroscopic/contrast films documenting final needle position and contrast flow (minimum two views) should be retained and made available upon request.

Key Coverage Criteria

Epidural steroid injections (ESIs) for pain management are covered when reasonable and necessary per Local Coverage Determination L33906.
Epidural injection CPT codes 62321, 62323, 64479, 64480, 64483 or 64484 used for postoperative acute post-thoracotomy pain (G89.12) or other acute postprocedural pain (G89.18) are exempt from the LCD diagnosis-code restrictions.
Epidural injection CPT 62323 used as part of an implantable infusion pump trial for severe spasticity is adjudicated under NCD 280.14 and is exempt from the diagnosis-code restrictions in this article.
Epidural injection CPT 62323 used for cerebrospinal fluid flow imaging (cisternography CPT 78630) is exempt from the diagnosis-code restrictions and should be billed on the same claim.
Diagnostic selective nerve root blocks (DSNRBs) are coded identically to epidural injections and when performed on a transforaminal level (TFESI CPT 64479, 64480, 64483, 64484) the -KX modifier must be appended to distinguish DSNRB from therapeutic epidural injection.
Nerve conduction studies (NCS) without needle EMG (NEMG) are allowed for individuals being evaluated for carpal tunnel syndrome or tarsal tunnel syndrome when one of the following ICD-10-CM codes is reported: G56.01, G56.02, G56.03, G56.11, G56.12, G56.13, G56.21, G56.22, G56.23, G57.51, G57.52, or G57.53.

20 Active Policies

CGS-J15-L39015, Epidural Steroid Injections for Pain Management

J15

CGS-J18-L39015, Epidural Steroid Injections for Pain Management

J18

A58777, Billing and Coding: Epidural Steroid Injections for Pain Management

WPS-J5-L39054, Epidural Steroid Injections for Pain Management

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B02.23, Postherpetic polyneuropathy