Does H93.3X3 require prior authorization?

No, H93.3X3 does not require prior authorization (high confidence). Covered without prior authorization.

`H93.3X3`, Disorders of bilateral acoustic nerves

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
Refer to LCD L34975 for the detailed reasonable and necessary clinical criteria and documentation required to support coverage of NEPs.
Use CPT codes 95925, 95926, 95927, 95928, 95929, 95938, and 95939 for Somatosensory Evoked Potentials/Responses (SEPs/SERs).
Use CPT codes 92651, 92652, and 92653 for Brainstem Auditory Evoked Potentials/Responses (BAEPs/BAERs).

Neurophysiology Evoked Potentials (NEPs) — including Somatosensory Evoked Potentials (SEPs), Brainstem Auditory Evoked Potentials (BAEPs/BAERs), and Visual Evoked Potentials (VEPs/VERs) — are covered when determined to be reasonable and necessary in accordance with LCD L34975.
CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
CPT codes 92553, 92557, and 92568 are allowable when the beneficiary has current long-term use of ototoxic antibiotics.
The professional component (PC) of CPT codes 92537, 92538, 92541, 92542, 92544, 92545, 92546, 92587, 92588, 92651, 92652, and 92653 may be reported when the PC is performed in inpatient, outpatient, rehabilitation facilities, nursing facilities (when Part A benefits are exhausted), hearing and speech centers, independent clinics, or independent diagnostic testing facilities (IDTF).
Technical-only CPT codes 92547, 92552, 92553, 92555, 92556, 92562, 92563, 92565, 92571, 92572, 92575, 92576, 92577, 92582, 92583, and 92584 may be reported when performed in office settings, clinics, hearing and speech centers, and nursing facilities.

NOVITAS-JH-L34975, Neurophysiology Evoked Potentials (NEPs)

NOVITAS-JH-L35007, Vestibular and Audiologic Function Studies

NOVITAS-JL-L34975, Neurophysiology Evoked Potentials (NEPs)

NOVITAS-JL-L35007, Vestibular and Audiologic Function Studies

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