Does H49.00 require prior authorization?

No, H49.00 does not require prior authorization (high confidence). Covered without prior authorization.

`H49.00`, Third [oculomotor] nerve palsy, unspecified eye

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The patient's medical record must contain documentation that fully supports the medical necessity for the visual fields testing in accordance with the applicable LCD.
Documentation should include relevant medical history, a physical examination, and results of pertinent diagnostic tests or procedures supporting the need for visual fields testing.
The diagnosis code(s) reported on the claim must best describe the patient's condition for which the visual fields testing was performed.
Refer to NCCI and OPPS requirements prior to billing Medicare to ensure coding compliance and to determine any bundling or packaging edits.

Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
Assessment of anterior chamber angle (ACA) configuration and detection of occludable/angle-closure (anterior segment OCT (AS-OCT) may be used for assessment of the anterior chamber angle and as a rapid screening tool for detection of occludable angles; cited studies include Nolan et al. 2007, Pekmezci et al. 2009, Desmond et al. 2022)
None. (The CPB states anterior segment OCT is considered experimental and investigational for all indications; see Limitations below.)
In vivo imaging and measurement of anterior segment ocular structures such as corneal and LASIK flap thickness (Visante OCT indication: "indicated for the in vivo imaging and measurement of ocular structures in the anterior segment such as corneal and laser in situ keratomileusis (LASIK) flap thickness (FDA, 2005).")
Measurement of central corneal thickness (CCT) and para-central corneal thickness (PCCT) (comparative studies vs ultrasound pachymetry and Orbscan II cited: Zhao et al. 2007; Li et al. 2007; Ho et al. 2007)
Quantitative assessment of anterior chamber parameters (AOD, ARA, TISA, ACD, angle metrics) for research and clinical evaluation (multiple reproducibility/measurement studies cited, e.g., Radhakrishnan et al. 2007; Maram et al. 2015)

NGS-J6-L33574, Visual Fields Testing

A56551, Billing and Coding: Visual Fields Testing

FIRST_COAST-L33766, Visual Field Examination

A57637, Billing and Coding: Visual Field Examination

NGS-JK-L33574, Visual Fields Testing

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