Does D09.3 require prior authorization?

No, D09.3 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D09.3`, Carcinoma in situ of thyroid and other endocrine glands

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification (e.g., 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.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Ultrasound of soft tissues of the head and neck is covered when it is reasonable and necessary as defined by Local Coverage Determination L34027.
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.
Coverage applies for lab-developed tests (LDTs) for inherited cancer syndromes in patients with cancer when billed in accordance with MolDX LCD L38972.
Lab-developed tests for inherited cancer syndromes in patients with cancer as described in Local Coverage Determination (LCD) L39040 are the services addressed by this billing/coding guidance.
ESAs are appropriate to treat symptomatic anemia of chronic kidney disease in patients on dialysis when billed using ESRD-specific HCPCS codes (J0882, J0887, Q4081, Q5105) and documented diagnoses D63.1 and N18.6.

CGS-J15-L39017, MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

J15

CGS-J18-L39017, MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

J18

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

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