Does D31.60 require prior authorization?

No, D31.60 does not require prior authorization (high confidence). Covered without prior authorization.

`D31.60`, Benign neoplasm of unspecified site of unspecified orbit

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
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.

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.
Visual field examination is covered for patients with inflammation or disorders of the eyelids that may affect the visual field.
Visual field examination is covered for patients with a documented diagnosis of glaucoma.
Visual field examination is covered for glaucoma suspects, defined by increased intraocular pressure, inter-eye intraocular pressure asymmetry greater than 2–3 mm Hg, or optic nerve findings suspicious for glaucoma (asymmetric cupping, disc hemorrhage, absent or thinned temporal rim).
Visual field examination is covered for patients with a documented disorder of the optic nerve, neurologic visual pathway, or retina.

FIRST_COAST-L33766, Visual Field Examination

FIRST_COAST-L33933, Peripheral Nerve Blocks

A57637, Billing and Coding: Visual Field Examination

A56612, Billing and Coding: CT of the Head

A57788, Billing and Coding: Peripheral Nerve Blocks

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