Does H53.10 require prior authorization?

No, H53.10 does not require prior authorization (high confidence). Covered without prior authorization.

`H53.10`, Unspecified subjective visual disturbances

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, including 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.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

CPT code 93355 is used to report transesophageal echocardiography (TEE) performed during transcatheter intracardiac therapies.
When contrast is used for a complete TEE procedure (probe placement, image acquisition, interpretation and report), bill CPT code 93312 (HCPCS C8925 for OPPS billing).
For congenital anomalies, use CPT code 93315 (HCPCS C8926 for OPPS billing) for the complete contrast TEE procedure.
Hospitals should bill echocardiograms without contrast using the applicable Level 1 CPT code descriptors and guidelines.
Coverage for electroretinography (ERG) is determined by Local Coverage Determination (LCD) L37371; ERG is covered only when reasonable and necessary per LCD L37371.
Taped and un-taped visual field testing count as one unit of service for MUE (medically unlikely edits) purposes.

CGS-J15-L34394, Visual Fields Testing

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L34394, Visual Fields Testing

J18

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

WPS-J5-L34615, Visual Fields

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