Does E05.91 require prior authorization?

No, E05.91 does not require prior authorization (high confidence). Covered without prior authorization.

`E05.91`, Thyrotoxicosis, unspecified with thyrotoxic crisis or storm

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification (e.g., 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.

Ultrasound of soft tissues of the head and neck is covered when it is reasonable and necessary as defined by Local Coverage Determination L34027.
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.
An ECG is covered when the result is relevant to the management, diagnosis, or treatment of the patient.
A separate ECG on the same day as a cardiac stress test is payable only when it provides additional clinically necessary information beyond the stress test (e.g., to rule out acute myocardial infarction prior to performing the stress test).
Rhythm ECGs are covered when used to evaluate signs or symptoms suggesting a cardiac rhythm disorder.

FIRST_COAST-L34027, Ultrasound, Soft Tissues of Head and Neck

A57029, Billing and Coding: Ultrasound, Soft Tissues of Head and Neck

FIRST_COAST-L34021, Sedimentation Rate, Erythrocyte

A57657, Billing and Coding: Sedimentation Rate, Erythrocyte

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