Does H65.20 require prior authorization?

No, H65.20 does not require prior authorization (high confidence). Covered without prior authorization.

`H65.20`, Chronic serous otitis media, unspecified ear

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This document (background/review section) does not specify documentation requirements, prior authorization criteria, frequency limits, ICD-10 or CPT codes, or other medical-record requirements for phonophoresis.
No explicit 'Documentation Requirements' section is present in this text chunk.
None specified in the policy.

Other anatomic or medical conditions that contraindicate the use of an air conduction hearing aid.
*Please refer to the Discussion section of this document for a list of device-specific thresholds.
II. Unilateral Hearing Loss (Conductive, Mixed or Sensorineural)
The following devices are consideredmedically necessaryfor the age groups specified(criterion A) when the audiologic (criterion B) and medical condition (criterion C) criteria listed belowhave been met:
Devices:Fully- or partially-implantable bone conduction (bone-anchored) hearing aid, including as an alternative to an air conduction hearing aid for individuals 5 years of age or older;orA transcutaneously worn bone conduction hearing aid that is applied to the head with a headband or adhesive adapter,regardless of age;and
Fully- or partially-implantable bone conduction (bone-anchored) hearing aid, including as an alternative to an air conduction hearing aid for individuals 5 years of age or older;or

ANTHEM-CG-SURG-82, Bone-Anchored and Bone Conduction Hearing Aids

ANTHEM-CG-SURG-117, Balloon Dilation of the Eustachian Tubes

AETNA-CPB-0210, Phonophoresis

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