Does G90.09 require prior authorization?

No, G90.09 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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`G90.09`, Other idiopathic peripheral autonomic neuropathy

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.

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.
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-J18-L35897, Nerve Conduction Studies and Electromyography

J18

A57551, Billing and Coding: Autonomic Function Testing

A57478, Billing and Coding: Nerve Conduction Studies and Electromyography

WPS-J5-L34594, Nerve Conduction Studies and Electromyography

WPS-J5-L35124, Autonomic Function Testing

A57024, Billing and Coding: Autonomic Function Testing

NGS-J6-L35098, Nerve Conduction Studies and Electromyography

NGS-J6-L36236, Autonomic Function Testing

A57668, Billing and Coding: Nerve Conduction Studies and Electromyography

WPS-J8-L34594, Nerve Conduction Studies and Electromyography

WPS-J8-L35124, Autonomic Function Testing

A57651, Billing and Coding: Autonomic Function Tests

FIRST_COAST-L33609, Autonomic Function Tests

NOVITAS-JH-L35395, Autonomic Function Tests

NOVITAS-JH-L35138, Routine Foot Care

NGS-JK-L35098, Nerve Conduction Studies and Electromyography

NGS-JK-L36236, Autonomic Function Testing

A52996, Billing and Coding: Routine Foot Care

NOVITAS-JL-L35138, Routine Foot Care

`G90.09`, Other idiopathic peripheral autonomic neuropathy

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

G90.09, Other idiopathic peripheral autonomic neuropathy

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`G90.09`, Other idiopathic peripheral autonomic neuropathy