Does D23.39 require prior authorization?

No, D23.39 does not require prior authorization (high confidence). Covered without prior authorization.

`D23.39`, Other benign neoplasm of skin of other parts of face

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The performing provider must maintain medical record documentation that clearly supports the medical necessity of the billed service and include that documentation in the patient's record for review upon request.
Documentation should state whether the block was diagnostic or therapeutic, include pre- and post-procedure evaluations, and document patient education and the assessment of procedural outcome.
Documentation must support coverage criteria in the LCD 'Indications and Limitations of Coverage and/or Medical Necessity' section and the provider should document why services cannot be rendered by the surgeon when applicable.
For services requiring a referring/ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.

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).
Use CPT 11200 for removal of skin tags and report 1 unit of service.

CGS-J15-L33944, Blepharoplasty

J15

CGS-J15-L34393, Ocular Photography - External

J15

CGS-J15-L39506, Cosmetic and Reconstructive Surgery

J15

CGS-J15-L34200, Removal of Benign Skin Lesions

J15

CGS-J18-L34393

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