Does D44.0 require prior authorization?

No, D44.0 does not require prior authorization (high confidence). Covered without prior authorization.

`D44.0`, Neoplasm of uncertain behavior of thyroid gland

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The performing provider must maintain medical record documentation that clearly supports the medical necessity of the billed service and include that documentation in the patient's record for review upon request.
Documentation should state whether the block was diagnostic or therapeutic, include pre- and post-procedure evaluations, and document patient education and the assessment of procedural outcome.
Documentation must support coverage criteria in the LCD 'Indications and Limitations of Coverage and/or Medical Necessity' section and the provider should document why services cannot be rendered by the surgeon when applicable.
For services requiring a referring/ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.

CPT codes 64400-64530 for peripheral nerve blocks may be reported on the date of surgery when performed for postoperative pain management only if the operative anesthesia is general anesthesia, subarachnoid injection, or epidural injection and the adequacy of intraoperative anesthesia is not dependent on the peripheral nerve block.
Peripheral nerve block services that are separate, medically necessary services which cannot be rendered by the surgeon may be reported if the surgeon documents the reason for referral and the additional services are justified in the medical record.
Thyroid nodule molecular testing is covered when it meets the clinical indications and medical necessity criteria specified in the attached Local Coverage Determination (LCD).
Molecular testing for risk stratification of thyroid nodules is covered consistent with MolDX Local Coverage Determination L39720.
Coverage for a second, unrelated thyroid nodule with indeterminate pathology may be considered if supporting clinical documentation is provided.
Coverage is allowed for nodules with indeterminate cytology defined as Bethesda category III or IV.

CGS-J15-L39650, MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules

J15

CGS-J15-L34356, Erythropoiesis Stimulating Agents (ESA)

J15

CGS-J15-L40386, Erythropoiesis Stimulating Agents (ESA)

J15

CGS-J18-L34356, Erythropoiesis Stimulating Agents (ESA)

J18

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