Does B55.9 require prior authorization?

No, B55.9 does not require prior authorization (high confidence). Covered without prior authorization.

`B55.9`, Leishmaniasis, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Verify and document compliance with applicable NCCI edits and OPPS packaging rules prior to billing.
Include a valid ICD-10-CM diagnosis code on the claim that best describes the patient's condition for which the heavy metal test was performed.
For diagnostic heavy metal tests, report the test result on the claim if known; if the result is not known, report the symptoms that prompted the test.
When required, report the referring/ordering physician's name and NPI on the claim.

Acanthamoeba in corneal ulceration
Actinomyces, for identification of actinomyces species in tissue specimens
Adenovirus, to diagnose adenovirus myocarditis, and to diagnose adenovirus infection in immunocompromised hosts, including transplant recipients
Anaplastic lymphoma kinase (ALK) testing as an alternative to FISH for selecting individuals for ALK inhibitor therapy
Avian influenza A virus, for diagnosis of avian influenza A (H5N1) in persons with both: Symptoms consistent with Avian influenza A virus (see background); and A history of travel to or contact with persons or birds from a country with documented H5N1 avian influenza infections within 10 days of symptom onset.
Babesiosis (Babesia spp.), diagnosis

NGS-J6-L35074, Heavy Metal Testing

A56767, Billing and Coding: Heavy Metal Testing

NGS-JK-L35074, Heavy Metal Testing

AETNA-CPB-0650, Polymerase Chain Reaction Testing: Selected Indications

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