Does G97.61 require prior authorization?

No, G97.61 does not require prior authorization (high confidence). Covered without prior authorization.

`G97.61`, Postprocedural hematoma 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)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
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.

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.
Covered CPT code if selection criteria are met: 76800 — "Ultrasound, spinal canal and contents"
Ultrasound of the spine and para-spinal tissues is medically necessary in newborns and infants for detection of sequelae of injury (e.g., hematoma after spinal tap or birth injury; post-traumatic leakage of cerebrospinal fluid; and sequelae of prior instrumentation, infection, or hemorrhage)
Ultrasound of the spine and para-spinal tissues is medically necessary in newborns and infants for evaluation of suspected defects such as cord tethering, diastematomyelia, hydromyelia, and syringomyelia
Ultrasound of the spine and para-spinal tissues is medically necessary in newborns and infants for guidance for lumbar puncture
Ultrasound of the spine and para-spinal tissues is medically necessary in newborns and infants for lumbosacral stigmata known to be associated with spinal dysraphism

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

CIGNA-CPG038, Spinal Ultrasound

AETNA-CPB-0628, Spinal Ultrasound

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

A56612, Billing and Coding: CT of the Head