Does H10.10 require prior authorization?

No, H10.10 does not require prior authorization (high confidence). Covered without prior authorization.

`H10.10`, Acute atopic conjunctivitis, unspecified eye

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The number of doses prepared must be specified on the claim/documentation when billing for antigen preparation.
Maintain an initial AIT extract prescription form containing patient identifiers (name, patient number, birth date, telephone number, picture if available) to reduce risk of misadministration.
Document preparation information including name of person preparing the extract and date of preparation.
Document AIT extract content for each allergen: common name or genus and species, extract manufacturer, manufacturer's extract concentration, volume of manufacturer's extract added, type and volume of diluent added (if any), lot number, and expiration date of each component.

CPT 95165 covers physician preparation and provision of non-venom allergen antigen extracts (includes calculations for concentration and volume) but does not include administration of the antigen.
Payment may be made for antigens prepared for a particular patient when the antigens are prepared by a Doctor of Medicine (MD) or Doctor of Osteopathy (DO) who has examined the patient and determined a treatment plan and dosage regimen.
Antigens must be administered in accordance with the physician's plan of treatment and may be given by an MD/DO or a properly instructed person under physician supervision.
Maintenance allergen immunotherapy claims are covered when properly billed with the EJ modifier to indicate maintenance therapy.
CPT 95165 may be billed for the physician preparation of vials of non-venom antigens for subcutaneous allergen immunotherapy (SCIT) when the physician performs calculations for concentration and volume based on the patient’s skin test results and history.
Payment may be made for antigen doses prepared for a particular patient only if the antigens are prepared by a Doctor of Medicine (MD) or Doctor of Osteopathy (DO) who has examined the patient and determined a treatment plan and dosage regimen.

CGS-J15-L40056, Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

J15

CGS-J18-L40056, Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

J18

WPS-J5-L40195, Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

A60276, Billing and Coding: Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

Ask Backwork about documentation requirements, denial risks, or coverage in your state.