Does D31.00 require prior authorization?

No, D31.00 does not require prior authorization (high confidence). Covered without prior authorization.

`D31.00`, Benign neoplasm of unspecified conjunctiva

ICD-10-CM

No Prior Auth Required

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 record must be legible and include appropriate patient identification information such as 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 to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
Fundus photography is consideredmedically necessaryto document abnormalities or disease processes (not screening) affecting the eye or to follow the progress of such eye disease when the results of fundus photography will be used to direct therapy and improve clinical outcomes. [...]
Diabetic retinopathy
To further evaluate or monitor glaucoma or glaucoma suspects
Retinal detachment and defects

FIRST_COAST-L33766, Visual Field Examination

FIRST_COAST-L33933, Peripheral Nerve Blocks

A57637, Billing and Coding: Visual Field Examination

ANTHEM-CG-MED-47, Fundus Photography

A57788, Billing and Coding: Peripheral Nerve Blocks

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