Does H51.9 require prior authorization?

No, H51.9 does not require prior authorization (high confidence). Covered without prior authorization.

`H51.9`, Unspecified disorder of binocular movement

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.
NC-stat testing (CPT 95905) is allowed when the beneficiary has a high pre-test or prior probability of Carpal Tunnel Syndrome (CTS), limited to one service per arm.
Use CPT 95870 for sampling muscles other than the paraspinals associated with the extremities that have been tested.
OnabotulinumtoxinA (Botox) medically necessary indications (initial approval): Achalasia — Treatment of achalasia when the member has tried and failed or is a poor candidate for conventional therapy such as pneumatic dilation and surgical myotomy.
Botulinum toxin type A has become 1st-line therapy for Frey's syndrome.
Botulinum toxin type A therapy for blepharospasm

NGS-J6-L35098, Nerve Conduction Studies and Electromyography

A57668, Billing and Coding: Nerve Conduction Studies and Electromyography

FIRST_COAST-L33766, Visual Field Examination

A57637, Billing and Coding: Visual Field Examination

NGS-JK-L35098

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