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ICD-10-CM H93.A9, Pulsatile tinnitus, unspecified ear | No Prior Auth

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`H93.A9`, Pulsatile tinnitus, unspecified ear

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

This billing and coding guideline complements Local Coverage Determination (LCD) L34424 for Magnetic Resonance Angiography; refer to LCD L34424 for clinical indications, medical necessity criteria, and specific coding rules.

Key Coverage Criteria

Automated auditory brainstem responses (ABR), evoked otoacoustic emissions (OAE), or OAE followed by ABR testing is consideredmedically necessaryto screen for hearing disorders foranyof the following indications:
As initial screening for newborns and infants;or
Infants (age less than 1 year) admitted to an ICU for 2 or more days;or
Neonates during the 1st month of life when exposed to potential causes of hearing loss (for example, chemotherapy, hyperbilirubinemia that requires exchange transfusions, meningitis, or culture-positive sepsis);or
To screen for hearing disorders in infants and children when behavioral audiometry is not reliable related to, but not limited to, inability to cooperate with other methods of hearing testing;or
To screen for hearing disorders in children less than 36 months of age who passed the neonatal hearing screening test but are at risk of having sensorineural hearing loss;or

2 Active Policies

ANTHEM-CG-MED-49, Auditory Brainstem Responses (ABRs) and Evoked Otoacoustic Emissions (OAEs) for Hearing Disorders

A56775, Billing and Coding: Magnetic Resonance Angiography

Related Codes

H90.A21(2 policies)H90.A32(2 policies)H90.A11(2 policies)H90.A12(2 policies)H90.A22(2 policies)H90.A31(2 policies)D33.3(2 policies)H93.011(2 policies)

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