Does G97.31 require prior authorization?

No, G97.31 does not require prior authorization (high confidence). Covered without prior authorization.

`G97.31`, Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating a nervous system procedure

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

When billing these procedures after carotid endarterectomy, include the surgery date and the phrase 'carotid endarterectomy' in the claim narrative.
When reporting a reduced (unilateral/limited) service, append modifier -52 and include an explanation of the reduced service in Item 19 of the CMS-1500 form or electronic equivalent; any appropriate supporting documentation may be submitted with the claim.
Follow Novitas LCD L35397 for the reasonable and necessary documentation requirements and frequency limitations, and consult NCCI edits for correct coding combinations prior to billing Medicare.

Non-invasive cerebrovascular arterial studies are covered when reasonable and necessary as defined by Novitas Local Coverage Determination (LCD) L35397.
Duplex post-interventional follow-up studies (typically limited and unilateral) are covered for evaluation after cerebrovascular intervention.
Vascular studies performed after carotid endarterectomy are covered when the claim includes the procedure date and the narrative 'carotid endarterectomy.'
Coverage for thoracic aortography and carotid, vertebral, and subclavian angiography is determined by Local Coverage Determination L35035; services are covered when reasonable and necessary per that LCD.
Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.
Aortography and peripheral angiography are covered when reasonable and necessary per Local Coverage Determination L36767 and when documentation supports the selected ICD-10-CM diagnosis and medical necessity.

WPS-J5-L35753, Non-Invasive Cerebrovascular Studies

A57592, Billing and Coding: Non-Invasive Cerebrovascular Studies

WPS-J8-L35753, Non-Invasive Cerebrovascular Studies

FIRST_COAST-L33977, Transcranial Doppler Studies

A57056, Billing and Coding: Aortography and Peripheral Angiography

FIRST_COAST-L36767, Aortography and peripheral angiography

A57064, Billing and Coding: Duplex Scan of Lower Extremity Arteries

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

NOVITAS-JH-L35035, Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography

NOVITAS-JL-L35035, Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography

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

A52992, Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies

A56631, Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography

A56612, Billing and Coding: CT of the Head

A56421, Billing and Coding: CT of the Abdomen and Pelvis

A57204, Billing and Coding: MRI and CT Scans of the Head and Neck

AETNA-CPB-0221, Quantitative EEG (Brain Mapping)

A57633, Billing and Coding: Transcranial Doppler Studies