Does G62.9 require prior authorization?

No, G62.9 does not require prior authorization (medium confidence). Covered without prior authorization by at least one policy, though another does not cover it.

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`G62.9`, Polyneuropathy, unspecified

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Documentation Required

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.
Total the number of keratotic lesions debrided and select the most appropriate CPT code 11055-11057 based on that total (example: code 11056 for two to four lesions).

Key Coverage Criteria

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
Autonomic function testing is covered to confirm or exclude a specific autonomic nervous system disorder when medically necessary.
Repeat autonomic testing for patients with a diagnosed autonomic disorder is covered when there is a documented change in clinical status or a response to a therapeutic intervention.
CPT 64450 is appropriate when a qualified health care professional performs a direct injection (nerve block) of an anesthetic agent and/or steroid into a peripheral nerve for treatment of peripheral neuropathy.
Code 64450 addresses the additional work of performing a nerve block (direct peripheral nerve injection) rather than injections into surrounding subcutaneous tissue.
NC-stat testing (CPT 95905) is allowed when the beneficiary has a high pre-test or prior probability of Carpal Tunnel Syndrome (CTS), limited to one service per arm.

20 Active Policies

A57589, Billing and Coding: Nerve Blocks for Peripheral Neuropathy

NGS-J6-L39189, Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)

NGS-J6-L35098, Nerve Conduction Studies and Electromyography

A57024, Billing and Coding: Autonomic Function Testing

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G62.9, Polyneuropathy, unspecified