Does H16.329 require prior authorization?

No, H16.329 does not require prior authorization (high confidence). Covered without prior authorization.

`H16.329`, Diffuse interstitial keratitis, unspecified eye

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information such as complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
Retinal degenerative diseases / RPE-associated disorders (e.g., ARMD, inherited retinal diseases, retinitis pigmentosa, Leber congenital amaurosis): human pluripotent stem cell (hPSC)-based retinal organoid approaches and cell-based RPE therapies are under preclinical/early clinical development and proposed as therapeutic candidates (M'Barek et al. 2019; Singh et al. 2021).
Autism spectrum disorder (children age ~2–7 years) — single intravenous infusion of autologous or allogeneic umbilical cord blood (UCB) evaluated for safety and efficacy in phase I and phase II trials.
Stiff‑person spectrum disorder (SPSD) — autologous non‑myeloablative hematopoietic stem cell transplantation (AHSCT) studied in a prospective open‑label pilot trial with a subset of responders.
Retinal degenerative diseases (age‑related macular degeneration [ARMD], inherited retinal diseases including retinitis pigmentosa, Leber congenital amaurosis) — pluripotent stem cell‑based retinal organoid therapies described as preclinical/early translational approaches.
Ankylosing spondylitis (AS) and Sjogren's syndrome (SS) — mesenchymal stem cell (MSC) therapies reported in systematic reviews and small studies with suggested clinical/immunologic improvements.

FIRST_COAST-L33766, Visual Field Examination

A57637, Billing and Coding: Visual Field Examination

AETNA-CPB-0606, Hematopoietic Cell Transplantation for Autoimmune Diseases and Miscellaneous Indications

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