Does B77.0 require prior authorization?

No, B77.0 does not require prior authorization (high confidence). Covered without prior authorization.

`B77.0`, Ascariasis with intestinal complications

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.
Pregnant and considered to be at high risk for type 2 diabetes mellitus;or
Impaired fasting glucose has been found on other testing;or
Blood glucose testing is consideredmedically necessaryfor individuals who meet any of the following criteria (A through Q):
Signs or symptoms of either of the following:Hypoglycemia;orHyperglycemia;or

CGS-J15-L34005, Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J15

CGS-J18-L34005, Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J18

ANTHEM-CG-LAB-30, Outpatient Laboratory-based Blood Glucose Testing

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.