Does E83.50 require prior authorization?

No, E83.50 does not require prior authorization (high confidence). Covered without prior authorization.

`E83.50`, Unspecified disorder of calcium metabolism

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The medical record must clearly document the necessity for the vitamin D test(s), including the clinical indication, and must document any repeat testing and the frequency of repeat testing.
Medical records relating to the test must be made available to Medicare upon request.
Providers must follow Correct Coding Initiative (CCI) guidance for correct HCPCS/CPT coding and appropriate code combinations prior to billing Medicare; documentation must support the CPT/HCPCS codes billed.
For services requiring a referring/ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.

Vitamin D assay testing is covered when the medical record documents medical necessity for the test, including the clinical reason for testing and any planned repeat testing and frequency.
Vitamin D assay testing is covered when ordered for evaluation of a patient's vitamin D status and billed with a valid ICD-10-CM diagnosis code that best describes the patient's condition.
No specific clinical indications are listed in this article; follow the Local Coverage Determination (LCD) L39400 for indications for magnesium testing or services.
Inherited disorders of vitamin D and phosphate metabolism;or
Immobilization (for example, cerebral palsy or neuromuscular disease);or
Hepatic failure (cirrhosis or chronic liver disease);or

A57736, Billing and Coding: Vitamin D Assay Testing

NGS-J6-L37535, Vitamin D Assay Testing

NGS-JK-L37535, Vitamin D Assay Testing

A59186, Billing and Coding: Magnesium

A57718, Billing and Coding: Vitamin D Assay Testing

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