Does D31.10 require prior authorization?

No, D31.10 does not require prior authorization (high confidence). Covered without prior authorization.

`D31.10`, Benign neoplasm of unspecified cornea

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Medical records must include history and physical notes, laboratory results, and documentation of signs and symptoms that warrant the head/neck diagnostic imaging.
Accurate HCPCS/CPT coding must be submitted to differentiate CT and MRI scans from other radiology services and to support coverage determinations.
Documentation and supporting information must be available to Medicare upon request.
Providers should check and apply Correct Coding Initiative (CCI) edits and applicable LCD guidance for correct code combinations before billing.

CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
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.
Assessment of anterior chamber angle (ACA) configuration and detection of occludable/angle-closure (anterior segment OCT (AS-OCT) may be used for assessment of the anterior chamber angle and as a rapid screening tool for detection of occludable angles; cited studies include Nolan et al. 2007, Pekmezci et al. 2009, Desmond et al. 2022)
None. (The CPB states anterior segment OCT is considered experimental and investigational for all indications; see Limitations below.)

FIRST_COAST-L33933, Peripheral Nerve Blocks

A57637, Billing and Coding: Visual Field Examination

FIRST_COAST-L33766, Visual Field Examination

A57788, Billing and Coding: Peripheral Nerve Blocks

AETNA-CPB-0749, Anterior Segment Scanning Computerized Ophthalmic Diagnostic Imaging

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