Does H83.19 require prior authorization?

No, H83.19 does not require prior authorization (high confidence). Covered without prior authorization.

`H83.19`, Labyrinthine fistula, 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.
A valid order from the treating physician or non-physician practitioner is required (per CFR Title 42 §410.32(a)) and the ordering physician must appear on the audiologist claim.

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.
Vestibular function testing is covered when medically necessary to evaluate balance or suspected vestibular dysfunction and when other physiological, psychological, medication-related, or systemic causes of balance problems have been ruled out.
CPT 92537 (caloric vestibular testing) is intended for a complete caloric test consisting of bilateral bithermal irrigations (one warm and one cool irrigation for each ear).
CPT 92538 (monothermal irrigation) is used when both ears are irrigated with the same temperature (monothermal) and reported once for that bilateral monothermal procedure.

FIRST_COAST-L33966, Vestibular Function Tests

NOVITAS-JH-L35003, Intraoperative Neurophysiological Testing

NOVITAS-JH-L35007, Vestibular and Audiologic Function Studies

NOVITAS-JL-L35003, Intraoperative Neurophysiological Testing

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