Does E21.4 require prior authorization?

No, E21.4 does not require prior authorization (high confidence). Covered without prior authorization.

`E21.4`, Other specified disorders of parathyroid gland

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Billing and coding guidance in this policy complements and references Local Coverage Determination L34425; claims should be supported per the documentation requirements specified in LCD L34425.
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.

No specific clinical indications are listed in this billing/coding guidance; coverage determinations for MRI of the head and neck follow Local Coverage Determination L34425.
Ultrasound of soft tissues of the head and neck is covered when it is reasonable and necessary as defined by Local Coverage Determination L34027.
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.
Home-based ECG services (including additional payment above the base ECG amount for transportation) are covered when there is a documented medical need to perform the ECG in the patient's home, typically for homebound or bed-confined patients.

WPS-J5-L34658, Vitamin D Assay Testing

A57484, Billing and Coding: Vitamin D Assay Testing

WPS-J8-L34658, Vitamin D Assay Testing

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

FIRST_COAST-L34027

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