Does I71.03 require prior authorization?

No, I71.03 does not require prior authorization (high confidence). Covered without prior authorization.

`I71.03`, Dissection of thoracoabdominal aorta

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The ordering physician/nonphysician practitioner must state the clinical indication and medical necessity for the study in the order.
The performing provider must maintain a permanent record of the performed study and interpretation, and must retain a copy of the ordering provider’s order and the test results.
The report must describe the studies performed, note any contrast media or radiopharmaceuticals used, record any significant patient reactions or complications, and compare with prior relevant imaging.
Variations from normal size must be documented with measurements and the report should address specific clinical questions or explain why questions cannot be answered.

Non‑invasive abdominal/visceral vascular studies are covered when the test results will be used to directly inform or change the patient's clinical management.
A preoperative non‑invasive abdominal/visceral vascular study is covered as reasonable and necessary for patients undergoing bypass surgery (one preoperative scan considered reasonable).
Medically necessary follow‑up non‑invasive abdominal/visceral vascular studies after angioplasty are covered as indicated by the vascular distribution treated.
Non‑invasive abdominal/visceral vascular studies performed in the inpatient hospital (place of service 21) or emergency room (place of service 23) are permitted and are not subject to the routine once‑per‑year outpatient limitation.
Somatosensory testing is covered when medically reasonable and necessary and documented in the patient's medical record (relevant history, physical exam, and pertinent diagnostic test results).
Testing and interpretation are covered when ordered and/or furnished by qualified personnel who have documented training and experience in evoked potentials and electrodiagnostics per CMS guidance (accredited residency/fellowship, national certification, or accredited post-graduate training/AMA-AOA Category 1 CME).

CGS-J15-L33959, Cardiac Catheterization and Coronary Angiography

J15

CGS-J15-L35906, Somatosensory Testing

J15

CGS-J15-L34337, Transesophageal Echocardiography (TEE)

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J15-L34338

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