Does G71.20 require prior authorization?

No, G71.20 does not require prior authorization (high confidence). Covered without prior authorization.

`G71.20`, Congenital myopathy, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

When billing with a Z-code as the diagnosis, document the orthotic/prosthetic device name, date the patient received the device, and the date training/teaching began (if applicable).
Document actual SLP patient contact time in 15-minute increments and link units billed to the clinical notes showing time and skilled service provided.
For SGD services billed with CPT 92607 or 92609, retain documentation supporting selection/prescription, adaptation, and training provided to the patient.
If performing a re-evaluation, document clinical rationale and use the applicable evaluation CPT code with supporting clinical findings since no separate SLP re-evaluation CPT exists.

Home health speech-language pathology services must be billed using HCPCS G0153 (Speech-Language Pathology).
When treating memory disturbances not associated with mental disorders (e.g., post cerebrovascular accident), use ICD-10 R68.89 as the diagnosis code for the related LCD.
Use CPT 92607 for selection and prescription of speech-generating devices (SGDs) and CPT 92609 for SGD adaptation and training.
Use CPT 92507 for speech/hearing treatment services (treatment code).
For re-evaluation in speech-language pathology, use the appropriate evaluation CPT code because CPT does not define a separate SLP re-evaluation code.
Occupational therapy is covered for patients with migraine (G43.xx) who require training to reduce pain during basic and instrumental activities of daily living, typically completed in 3–4 sessions.

CGS-J15-L35897, Nerve Conduction Studies and Electromyography

J15

CGS-J18-L35897, Nerve Conduction Studies and Electromyography

J18

A57478, Billing and Coding: Nerve Conduction Studies and Electromyography

WPS-J5-L34594, Nerve Conduction Studies and Electromyography

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