Does E83.00 require prior authorization?

No, E83.00 does not require prior authorization (high confidence). Covered without prior authorization.

`E83.00`, Disorder of copper metabolism, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Verify and document compliance with applicable NCCI edits and OPPS packaging rules prior to billing.
Include a valid ICD-10-CM diagnosis code on the claim that best describes the patient's condition for which the heavy metal test was performed.
For diagnostic heavy metal tests, report the test result on the claim if known; if the result is not known, report the symptoms that prompted the test.
When required, report the referring/ordering physician's name and NPI on the claim.

Chelation therapy is consideredmedically necessarytreatment for individuals with relevant clinical findings suggestive of heavy metal toxicity and a probable exposure history inanyof the following conditions when confirmed by laboratory testing*:
Individuals with disorders of iron metabolism (for example, primary or secondary hemochromatosis);or
Lead overload in cases of acute or long-term lead exposure;or
Individuals with disorders of copper metabolism (for example, Wilsonâs disease);or
Arsenic, mercury, iron, copper, or gold poisoning when long-term exposure and toxicity has been confirmed;or
Aluminum overload in individuals on chronic hemodialysis.

NGS-J6-L35074, Heavy Metal Testing

A56767, Billing and Coding: Heavy Metal Testing

NGS-JK-L35074, Heavy Metal Testing

ANTHEM-CG-MED-90, Chelation Therapy

ANTHEM-CG-LAB-20, Thyroid Testing

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