Does G11.19 require prior authorization?

No, G11.19 does not require prior authorization (high confidence). Covered without prior authorization.

`G11.19`, Other early-onset cerebellar ataxia

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.

Electrodiagnostic testing (EMG and/or nerve conduction studies) is indicated for evaluation of suspected carpal tunnel syndrome.
EMG and/or nerve conduction studies are indicated for evaluation of suspected radiculopathy.
EMG and/or nerve conduction studies are indicated for evaluation of suspected mononeuropathy (single-nerve entrapment or injury).
EMG and/or nerve conduction studies are indicated for evaluation of suspected polyneuropathy or mononeuropathy multiplex.
EMG is indicated for evaluation of suspected myopathy.
EMG and nerve conduction studies are indicated for evaluation of suspected motor neuropathies (e.g., amyotrophic lateral sclerosis).

CGS-J15-L35906, Somatosensory Testing

J15

CGS-J18-L35906, Somatosensory Testing

J18

A57597, Billing and Coding: Somatosensory Testing

A57478, Billing and Coding: Nerve Conduction Studies and Electromyography

WPS-J5-L34624

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