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ICD-10-CM D29.30, Benign neoplasm of unspecified epididymis | No Prior Auth

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`D29.30`, Benign neoplasm of unspecified epididymis

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

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.

Key Coverage Criteria

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)

5 Active Policies

FIRST_COAST-L33933, Peripheral Nerve Blocks

J9

ANTHEM-CG-RAD-27, Scrotal Ultrasound

CIGNA-0548, Scrotal Ultrasound

AETNA-CPB-0327, Infertility

A57788, Billing and Coding: Peripheral Nerve Blocks

Related Codes

D40.10(4 policies)D40.9(4 policies)D29.32(4 policies)D29.9(4 policies)D40.12(4 policies)D40.8(4 policies)D29.22(4 policies)C63.9(3 policies)

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Documentation should include pre-procedure and post-procedure evaluations of the patient.

Documentation should include patient education provided related to the procedure and expected outcomes.