Does B35.0 require prior authorization?

No, B35.0 does not require prior authorization (high confidence). Code is covered without prior authorization.

`B35.0`, Tinea barbae and tinea capitis

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

The CPB does not state specific, detailed documentation requirements; it indicates that CPT/ICD-10 codes are covered "if selection criteria are met." No explicit required medical record elements, prior-authorization items, or exact documentation checklists are provided in this document.
No explicit "Documentation Requirements" section is provided in this Clinical Policy Bulletin.
Billing limitation/note that may affect documentation: "Mohs micrographic surgery requires a single physician to act in 2 integrated, but separate and distinct capacities: surgeon and pathologist. If either of these responsibilities is delegated to another physician who reports his/her services separately, the use of the Mohs micrographic surgery CPT codes is inappropriate."

Medicinal leech therapy is medically necessary for salvage of vascularly compromised flaps (muscle, skin, and fat tissue surgically removed from one part of body to another).
Medicinal leech (Hirudo medicinalis) therapy is medically necessary for any of the following conditions: poor venous drainage (venous congestion/venous outflow obstruction).
Medicinal leech therapy is medically necessary for salvage of vascularly compromised replants (limbs or other body parts re-attached after traumatic amputation).
Medical maggots (larval therapy) are medically necessary for debridement of non-healing necrotic skin and soft tissue wounds including chronic diabetic foot ulcers.
Medical maggots are medically necessary for debridement of neuropathic foot ulcers.
Medical maggots are medically necessary for debridement of non-healing traumatic or post-surgical wounds.

ANTHEM-CG-LAB-20, Thyroid Testing

AETNA-CPB-0383, Mohs Micrographic Surgery

AETNA-CPB-0556, Bio-Surgery: Medicinal Leech Therapy and Medical Maggots

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