Does H30.90 require prior authorization?

No, H30.90 does not require prior authorization (high confidence). Covered without prior authorization.

`H30.90`, Unspecified chorioretinal inflammation, unspecified eye

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The diagnosis code(s) billed must best describe the patient’s condition for which the SCODI service was performed.
The patient's medical record must contain documentation that fully supports the medical necessity for SCODI services included within LCD L34380, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
For services requiring a referring or ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.

Scanning computerized ophthalmic diagnostic imaging (SCODI) is covered when the service meets the medical necessity criteria and is included within Local Coverage Determination L34380.
Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
Retisert (fluocinolone acetonide intravitreal 0.59 mg implant) and Yutiq (fluocinolone acetonide intravitreal 0.18 mg implant) for the treatment of chronic non-infectious uveitis (including birdshot chorioretinopathy) affecting the posterior segment of the eye in persons who do not respond to or are intolerant to conventional treatment (i.e., failed corticosteroid or immunosuppressive therapy);
Iluvien (fluocinolone acetonide intravitreal implant) for the treatment of diabetic macular edema in persons who have been previously treated with a course of corticosteroids and did not have a clinically significant rise in intraocular pressure.
Retisert: FDA approved ... for the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye.
On October 16, 2018, the FDA approved Yutiq, an intravitreal 0.18 mg fluocinolone acetonide implant for patients with chronic noninfectious posterior uveitis.

NGS-J6-L34380, Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

A56537, Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

FIRST_COAST-L33766, Visual Field Examination

A57637, Billing and Coding: Visual Field Examination

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