Does G83.34 require prior authorization?

No, G83.34 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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`G83.34`, Monoplegia, unspecified affecting left nondominant side

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

All documentation must be maintained in the patient's medical record, legible, include patient identification (e.g., full name, dates of service), and be made available to the contractor upon request.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
The submitted medical record must support the selected ICD-10-CM code(s), the submitted CPT/HCPCS code must describe the service performed, and the record must clearly document medical necessity, the indication for ordering the test, and a clear diagnostic impression.

Key Coverage Criteria

Nerve conduction studies (NCS) without needle EMG (NEMG) are allowed for individuals being evaluated for carpal tunnel syndrome or tarsal tunnel syndrome when one of the following ICD-10-CM codes is reported: G56.01, G56.02, G56.03, G56.11, G56.12, G56.13, G56.21, G56.22, G56.23, G57.51, G57.52, or G57.53.
NCS without NEMG is allowed for individuals with significant lymphedema in the affected extremity when ICD-10-CM code I89.0 is reported in addition to the primary diagnosis.
NCS without NEMG is allowed for individuals treated with anticoagulants when ICD-10-CM code Z79.01 or Z79.02 is reported in addition to the primary diagnosis.
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).

20 Active Policies

CGS-J15-L35897, Nerve Conduction Studies and Electromyography

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L35897, Nerve Conduction Studies and Electromyography

J18

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

A57478, Billing and Coding: Nerve Conduction Studies and Electromyography

WPS-J5-L35486, Pelvic Floor Dysfunction: Anorectal Manometry and EMG

WPS-J5-L34594, Nerve Conduction Studies and Electromyography

WPS-J5-L35753, Non-Invasive Cerebrovascular Studies

A57595, Billing and Coding: Pelvic Floor Dysfunction: Anorectal Manometry and EMG

A57592, Billing and Coding: Non-Invasive Cerebrovascular Studies

A57668, Billing and Coding: Nerve Conduction Studies and Electromyography

NGS-J6-L35098, Nerve Conduction Studies and Electromyography

WPS-J8-L35486, Pelvic Floor Dysfunction: Anorectal Manometry and EMG

WPS-J8-L35753, Non-Invasive Cerebrovascular Studies

WPS-J8-L34594, Nerve Conduction Studies and Electromyography

FIRST_COAST-L34859, Nerve Conduction Studies and Electromyography

A57123, Billing and Coding: Nerve Conduction Studies and Electromyography

NOVITAS-JH-L35081, Nerve Conduction Studies and Electromyography

NOVITAS-JH-L35397, Non-Invasive Cerebrovascular Arterial Studies

NGS-JK-L35098, Nerve Conduction Studies and Electromyography

`G83.34`, Monoplegia, unspecified affecting left nondominant side

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

G83.34, Monoplegia, unspecified affecting left nondominant side

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`G83.34`, Monoplegia, unspecified affecting left nondominant side