Does D89.40 require prior authorization?

No, D89.40 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D89.40`, Mast cell activation, unspecified

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Claims must include the appropriate CPT code, 1 unit of service (UOS), and the appropriate ICD-10-CM diagnosis code.
Additional medical necessity documentation must be submitted when more than 24 markers are tested.
Follow the associated Local Coverage Determination LCD L34215 for full documentation and coverage requirements not detailed here.
Avian influenza A virus (H5N1): documentation of symptoms consistent with Avian influenza A virus and history of travel to or contact with persons or birds from a country with documented H5N1 avian influenza infections within 10 days of symptom onset.

Flow cytometry is covered for examination of body fluids (including peripheral blood and cerebrospinal fluid), bone marrow, and lymphoreticular tissues (lymph nodes, tonsil, spleen).
Peripheral blood and fine needle aspirate specimens are acceptable for flow cytometry to avoid more invasive diagnostic procedures.
Coverage decisions are governed by the associated Local Coverage Determination LCD L34215 and its specific coverage criteria.
Acanthamoeba in corneal ulceration
Actinomyces, for identification of actinomyces species in tissue specimens
Adenovirus, to diagnose adenovirus myocarditis, and to diagnose adenovirus infection in immunocompromised hosts, including transplant recipients

AETNA-CPB-0650, Polymerase Chain Reaction Testing: Selected Indications

A57689, Billing and Coding: Lab: Flow Cytometry

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