Does C68.0 require prior authorization?

No, C68.0 does not require prior authorization (high confidence). Code is covered without prior authorization.

`C68.0`, Malignant neoplasm of urethra

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Select and report the appropriate CPT code for the Next-Generation Sequencing for Solid Tumors service.
Enter 1 unit of service (UOS) for the reported CPT code.
Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part B electronic claims (Loop 2400 or SV101-7 for 837P) and for Part B paper claims (Box 19).
Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part A electronic claims (Line SV202-7 for 837I) and on the UB-04 (Block 80) for Part A paper claims.

Flow cytometry is covered to detect antigens used as therapeutic targets in neoplastic disease.
Flow cytometry is covered for diagnosis and classification of hematopoietic neoplasms.
Flow cytometry is covered to assess biologic parameters associated with prognosis in hematopoietic neoplasms.
Flow cytometry is covered to detect residual neoplastic cells following therapy (minimal residual disease detection).
Flow cytometry is covered to monitor lymphocyte populations in patients with HIV infection.
Flow cytometry is covered to monitor lymphocyte subpopulations in post-transplant patients on immunosuppressive therapy.

CGS-J15-L38822, MolDX: Minimal Residual Disease Testing for Cancer

J15

CGS-J15-L40386, Erythropoiesis Stimulating Agents (ESA)

J15

CGS-J15-L40225, MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer

J15

CGS-J15-L34356, Erythropoiesis Stimulating Agents (ESA)

J15

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