Does D27.9 require prior authorization?

No, D27.9 does not require prior authorization (high confidence). Covered without prior authorization.

`D27.9`, Benign neoplasm of unspecified ovary

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Maintain all documentation in the patient's medical record and make it available to the contractor upon request; every page must be legible and include patient identifiers (complete name, dates of service).
Medical record 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 selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Documentation should state whether the block was performed for diagnostic or therapeutic purposes.

Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
N98.1: Hyperstimulation of ovaries
N99.83: Residual ovary syndrome
Benign neoplasm and neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct (D35.2 - D35.3; D44.3 - D44.4)
Neoplasm of uncertain behavior of female genital organs (D39.0 - D39.2)
Neoplasm of uncertain behavior of other and unspecified male genital organs (D40.8 - D40.9)

FIRST_COAST-L33933, Peripheral Nerve Blocks

ANTHEM-CG-LAB-32, Cancer Antigen 125 Testing

AMBETTER-CG-Onc-Algo-2025.1, Concert Genetic Oncology: Algorithmic Testing

AETNA-CPB-0327, Infertility

AETNA-CPB-0352, Tumor Markers

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