Does B76.9 require prior authorization?

No, B76.9 does not require prior authorization (high confidence). Covered without prior authorization.

`B76.9`, Hookworm disease, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

All services ordered or rendered must be signed and dated in the medical record, including a signed and dated office visit record or operative report.
An Advance Beneficiary Notice (ABN), Form CMS-R-131, should be signed by the beneficiary when applicable to indicate acceptance of financial responsibility.
The patient's medical record must include the ordering provider's assessment as it relates to the patient's complaint for that visit.
The medical record must document relevant medical history and the results of pertinent tests or procedures.

Colonoscopy/sigmoidoscopy/proctosigmoidoscopy is covered for surveillance of colonic neoplasia in patients with a history of colorectal cancer or colonic polyps.
A follow-up procedure is covered 1 year after surgery for treatment of colorectal cancer when the patient is identified as high-risk for colon cancer and is eligible for continued screenings.
C79.49 Secondary malignant neoplasm of other parts of nervous system
C79.51 Secondary malignant neoplasm of bone
C79.70 - C79.72 Secondary malignant neoplasm of adrenal gland
C79.82 Secondary malignant neoplasm of genital organs [prostate]

CGS-J15-L34005, Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J15

CGS-J18-L34005, Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J18

AETNA-CPB-0100, Cryoablation

A56456, Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

A56632, Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

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