Does I69.344 require prior authorization?

No, I69.344 does not require prior authorization (high confidence). Covered without prior authorization.

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`I69.344`, Monoplegia of lower limb following cerebral infarction affecting left non-dominant side

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

When NCSs and NEMG are performed on the same day for the same patient they must be reported on the same claim.
When billing non-covered services/tests report unlisted neurological CPT 95999 and provide a description of the service/test in block 80 (Part A) or box 19 (Part B) or electronic equivalent; failure to include this information will result in Part A claims being returned and Part B claims rejected.
All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and include the legible signature of the responsible physician or non-physician practitioner.

Key Coverage Criteria

Nerve conduction studies (NCS) without needle electromyography (NEMG) are allowed for individuals being evaluated for carpal tunnel syndrome or tarsal tunnel syndrome when one of the diagnosis codes G56.01, G56.02, G56.03, G56.11, G56.12, G56.13, G56.21, G56.22, G56.23, G57.51, G57.52, or G57.53 is reported.
NCS without NEMG is allowed for individuals with significant lymphedema in the affected extremity when diagnosis code I89.0 is reported in addition to the primary diagnosis.
NCS without NEMG is allowed for individuals treated with anticoagulants when diagnosis code Z79.01 or Z79.02 is reported in addition to the primary diagnosis.
Nerve conduction studies (NCS) without needle EMG (NEMG) are allowed for individuals being evaluated for carpal tunnel syndrome or tarsal tunnel syndrome when one of the following ICD-10-CM codes is reported: G56.01, G56.02, G56.03, G56.11, G56.12, G56.13, G56.21, G56.22, G56.23, G57.51, G57.52, or G57.53.
NCS without NEMG is allowed for individuals with significant lymphedema in the affected extremity when ICD-10-CM code I89.0 is reported in addition to the primary diagnosis.
NCS without NEMG is allowed for individuals treated with anticoagulants when ICD-10-CM code Z79.01 or Z79.02 is reported in addition to the primary diagnosis.

20 Active Policies

CGS-J15-L39857, Botulinum Toxin Injections

J15

CGS-J15-L38694, Computed Tomography Cerebral Perfusion Analysis (CTP)

J15

CGS-J18-L38694, Computed Tomography Cerebral Perfusion Analysis (CTP)

J18

CGS-J18-L39857, Botulinum Toxin Injections

J18

A57594, Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

WPS-J5-L35751, Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

WPS-J5-L40381, Botulinum Toxin Injections

WPS-J5-L39909, Botulinum Toxin Injections

NGS-J6-L39832, Botulinum Toxin Injections

WPS-J8-L35751, Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

WPS-J8-L40381, Botulinum Toxin Injections

WPS-J8-L39909, Botulinum Toxin Injections

A57123, Billing and Coding: Nerve Conduction Studies and Electromyography

FIRST_COAST-L34859, Nerve Conduction Studies and Electromyography

NOVITAS-JH-L35101, Psychiatric Codes

NOVITAS-JH-L35397, Non-Invasive Cerebrovascular Arterial Studies

NOVITAS-JH-L35081, Nerve Conduction Studies and Electromyography

NGS-JK-L39832, Botulinum Toxin Injections

NOVITAS-JL-L35081, Nerve Conduction Studies and Electromyography

A54095, Billing and Coding: Nerve Conduction Studies and Electromyography

`I69.344`, Monoplegia of lower limb following cerebral infarction affecting left non-dominant side

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

I69.344, Monoplegia of lower limb following cerebral infarction affecting left non-dominant side

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`I69.344`, Monoplegia of lower limb following cerebral infarction affecting left non-dominant side