Does G97.51 require prior authorization?

No, G97.51 does not require prior authorization (high confidence). Covered without prior authorization.

`G97.51`, Postprocedural hemorrhage of a nervous system organ or structure following 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.'
Duplex scan of lower extremity arteries is covered when medically necessary per LCD L33667, with the ordering/referring provider documenting signs and symptoms, relevant history (including known diagnoses and/or prior imaging) supporting evaluation of lower extremity arterial disease.
CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.

WPS-J5-L35753, Non-Invasive Cerebrovascular Studies

A57592, Billing and Coding: Non-Invasive Cerebrovascular Studies

WPS-J8-L35753, Non-Invasive Cerebrovascular Studies

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

FIRST_COAST-L33977, Transcranial Doppler Studies

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

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

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

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

A56612, Billing and Coding: CT of the Head

AETNA-CPB-0628, Spinal Ultrasound

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

CIGNA-CPG038, Spinal Ultrasound

A57633, Billing and Coding: Transcranial Doppler Studies