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ICD-10-CM H18.469, Peripheral corneal degeneration, unspecified eye | No Prior Auth

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`H18.469`, Peripheral corneal degeneration, unspecified eye

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

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).

Key Coverage Criteria

Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
Fuchs' endothelial dystrophy
Persons who recently had laser iridotomy for the treatment of narrow angle glaucoma (also known as acute angle-closure glaucoma or closed-angle glaucoma)
Anatomical narrow angles
Bullous keratopathy
Corneal edema

3 Active Policies

FIRST_COAST-L33766, Visual Field Examination

J9

A57637, Billing and Coding: Visual Field Examination

J9

AETNA-CPB-0681, Corneal Pachymetry

Related Codes

H18.629(3 policies)H28(3 policies)H18.531(3 policies)H18.601(3 policies)H25.011(3 policies)H26.9(3 policies)H18.461(3 policies)H40.1410(3 policies)

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The submitted CPT/HCPCS code must accurately describe the service performed.

If the provider of the service is other than the ordering/referring physician, that provider must maintain hard copy documentation of test results and interpretation and retain copies of the ordering/referring physician’s order for the studies.