Does D68.2 require prior authorization?

No, D68.2 does not require prior authorization (high confidence). Covered without prior authorization.

`D68.2`, Hereditary deficiency of other clotting factors

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Policy content not provided; unable to determine required documentation, prior authorization, or forms for AICC claims—manual review of the full policy required.
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.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
When billing CPT 84999 for the listed tests, include a note identifying the specific test in the Remarks (Part A) or Narrative (Part B) area of the claim.

Policy content not provided; unable to determine covered indications for AICC NCD 110.3—manual review of the full policy required.
For tests that currently lack specific CPT codes (functional intracellular analysis and total antioxidant function), bill using CPT 84999 and add a note identifying which test was performed in the Remarks area for Part A claims and the Narrative area for Part B claims.
Coverage and reasonable/necessary determinations for assays for vitamins and metabolic function are governed by LCD L34914 and claims must meet that LCD's requirements to be covered.
Routine foot care is covered only when clinical documentation demonstrates the patient’s condition warrants the provider to render the services and that failure to provide the services would be hazardous to the beneficiary due to underlying medical condition(s), per CMS Pub 100-02, Ch.15, §290.
Flow cytometry is considered medically necessary for the evaluation of any of the following: Hematopoietic/hematologic cancers; Immunodeficiency disorders, including human immunodeficiency virus (HIV) and acquired immunodeficiency virus syndrome (AIDS); Paroxysmal nocturnal hemoglobinuria; Gestational trophoblastic disease; Transplantation.
Diagnosis and/or evaluation of hematopoietic cancers, including lymphomas and leukemia, plasma cell neoplasms, myelodysplastic syndromes, myeloproliferative neoplasms, and certain anemias (as described in General Background).

NOVITAS-JH-L34914, Assays for Vitamins and Metabolic Function

A56416, Billing and Coding: Assays for Vitamins and Metabolic Function

NOVITAS-JL-L34914, Assays for Vitamins and Metabolic Function

A57954, Billing and Coding: Routine Foot Care

CIGNA-0538, Flow Cytometry

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