Does D22.121 require prior authorization?

No, D22.121 does not require prior authorization (high confidence). Covered without prior authorization.

`D22.121`, Melanocytic nevi of left upper eyelid, including canthus

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

List the appropriate CPT code for the procedure and include any applicable modifiers; adhere to Medicare global surgery and CCI (correct coding initiative) rules for eyelid surgeries.
Submit physicians' services and diagnostic tests with a diagnosis code that supports medical necessity and code to the greatest level of specificity (full digit completeness).
Use the diagnosis code based on diagnostic test results as the primary diagnosis; if test results are normal or inconclusive, use the diagnosis code for the sign or symptom that prompted the test as the primary diagnosis.
When signs or symptoms are present, place the appropriate definitive diagnosis code in the first position and an available symptom diagnosis code in the second position on CMS-1500 item 21 (or electronic equivalent).

Blepharoplasty, blepharoptosis repair, or brow lift is covered when documented signs or symptoms of a functional abnormality of the upper eyelids are present as defined by the associated LCD (L34528).
CPT codes 64400-64530 for peripheral nerve blocks may be reported on the date of surgery when performed for postoperative pain management only if the operative anesthesia is general anesthesia, subarachnoid injection, or epidural injection and the adequacy of intraoperative anesthesia is not dependent on the peripheral nerve block.
Peripheral nerve block services that are separate, medically necessary services which cannot be rendered by the surgeon may be reported if the surgeon documents the reason for referral and the additional services are justified in the medical record.
Use CPT 11400-11446 when the excision is a full-thickness removal through the dermis including margins and including simple (non-layered) closure.
Use CPT 17110 for destruction of benign lesions other than skin tags or cutaneous vascular lesions for up to 14 lesions (report 1 unit).
Use CPT 17111 for destruction of benign lesions other than skin tags or cutaneous vascular lesions when 15 or more lesions are treated (report 1 unit).

CGS-J15-L34037, Flow Cytometry

J15

CGS-J15-L34200, Removal of Benign Skin Lesions

J15

CGS-J15-L34393, Ocular Photography - External

J15

CGS-J15-L39389, MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma

J15

CGS-J15-L33944

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