Does D09.20 require prior authorization?

No, D09.20 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D09.20`, Carcinoma in situ of unspecified eye

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This article provides billing and coding guidelines that complement Local Coverage Determination (LCD) L37176 for White Cell Colony Stimulating Factors; refer to LCD L37176 for specific coverage criteria, indications, and limitations.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information such as complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.

Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
Destruction of a skin lesion is covered only when the medical record documents the lesion as malignant by a corresponding pathology report or a clinical description consistent with skin malignancy.
The medical record must include lesion size and lesion location to support medical necessity for destruction of a malignant skin lesion.
Services are covered only when they meet all applicable indications and limitations in LCD L33813, CMS payment policy manuals, any relevant national coverage determinations, and Medicare payment rules.
Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
Lab-developed tests for inherited cancer syndromes in patients with cancer (per LCD L38966) are covered when billed with the required claim elements specified in this policy.

A58756, Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

WPS-J5-L39040, MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

WPS-J8-L39040, MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

FIRST_COAST-L33933, Peripheral Nerve Blocks

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