Does H71.90 require prior authorization?

No, H71.90 does not require prior authorization (high confidence). Covered without prior authorization.

`H71.90`, Unspecified cholesteatoma, 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.
The test must be ordered by the operating surgeon and the order must be present in the medical record.

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.
Covered for surgery resulting from traumatic injury to the spinal cord or brain when monitoring can identify or prevent further neurologic injury.
Covered for surgery or embolization of intracranial arteriovenous malformations (AVMs) and for spinal cord AVM surgery.
Intraoperative neurophysiological testing is covered for surgery of the aortic arch, its branch vessels, or thoracic aorta (including carotid artery surgery) when there is risk of cerebral or spinal cord ischemia.

NOVITAS-JH-L35003, Intraoperative Neurophysiological Testing

NOVITAS-JL-L35003, Intraoperative Neurophysiological Testing

A56722, Billing and Coding: Intraoperative Neurophysiological Testing

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