Does H71.00 require prior authorization?

No, H71.00 does not require prior authorization (high confidence). Covered without prior authorization.

`H71.00`, Cholesteatoma of attic, unspecified ear

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 must be legible and include patient identification and dates of service.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing care to the patient.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
See appendix for additional details on documentation requirements (policy references an appendix)

Continuous intraoperative neurophysiologic monitoring provided one-on-one in the operating room (CPT 95940) is covered when it supports the covered indications in LCD L35003.
Report continuous intraoperative neurophysiologic monitoring in the operating room (95940) in addition to monitoring services provided from outside the operating room (G0453); coverage includes interpretation of baseline studies and removal of electrodes at the end of the procedure when supporting the LCD indications.
Reimbursement may be made for covered intraoperative monitoring when performed at POS 19, POS 21, POS 22, or POS 24.
Intraoperative EMG monitoring of the facial nerve during surgery for cholesteatoma, including mastoidotomy or mastoidectomy
ICD-10 codes covered if selection criteria are met for intraoperative SEPs (as listed): "H93.3x1 - H93.3x9" Disorders of acoustic nerve [compression].
ICD-10 codes covered if selection criteria are met for intraoperative SEPs (as listed): "I06.0 - I06.9" Diseases of aortic valve.

NOVITAS-JH-L35003, Intraoperative Neurophysiological Testing

NOVITAS-JL-L35003, Intraoperative Neurophysiological Testing

A56722, Billing and Coding: Intraoperative Neurophysiological Testing

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

AETNA-CPB-0697

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