Does H35.60 require prior authorization?

No, H35.60 does not require prior authorization (high confidence). Covered without prior authorization.

`H35.60`, Retinal hemorrhage, 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.
ICD-10 codes covered if selection criteria are met: H35.051 - H35.059 Retinal neovascularization, unspecified
Indocyanine green angiography when it is used as an adjunct to fluorescein angiography in the diagnosis and management/treatment of any of the following conditions: Acute posterior multi-focal placoid pigment epitheliopathy
ICD-10 codes covered if selection criteria are met: C54.1 Malignant neoplasm of endometrium
ICD-10 codes covered if selection criteria are met: C69.30 - C69.32 Malignant neoplasm of choroid [not covered for choroidal melanoma]
Indocyanine green angiography when it is used as an adjunct to fluorescein angiography in the diagnosis and management/treatment of any of the following conditions: Exudative senile macular degeneration

FIRST_COAST-L33766, Visual Field Examination

A57637, Billing and Coding: Visual Field Examination

AETNA-CPB-0111, Indocyanine Green Angiography

AETNA-CPB-0354, YAG Laser in Ophthalmology and Other Selected Indications

AETNA-CPB-0777, Novel Injection Methods

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