Does I79.8 require prior authorization?

No, I79.8 does not require prior authorization (high confidence). Covered without prior authorization.

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`I79.8`, Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.

When reporting an ICD-10-CM code that falls under the active care requirement, report the date the beneficiary was last seen by the MD, DO, or qualified NPP responsible for treating the underlying condition in line 19 of the CMS-1500 or the electronic equivalent.

Key Coverage Criteria

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
Diagnostic abdominal aortography and renal angiography are covered when they meet the reasonable and necessary clinical requirements specified in LCD L35092.
When femoral or iliac angiography is performed at the time of coronary angiography, bill using HCPCS code G0278.
MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.

20 Active Policies

CGS-J15-L34246, Routine Foot Care and Debridement of Nails

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

CGS-J18-L34246, Routine Foot Care and Debridement of Nails

J18

A57759, Billing and Coding: Routine Foot Care and Debridement of Nails

NGS-J6-L33627, Non-Invasive Vascular Studies

NGS-J6-L33633, Magnetic Resonance Angiography (MRA)

NGS-J6-L33636, Routine Foot Care and Debridement of Nails

A56747, Billing and Coding: Magnetic Resonance Angiography (MRA)

A56758, Billing and Coding: Non-Invasive Vascular Studies

FIRST_COAST-L36767, Aortography and peripheral angiography

A57056, Billing and Coding: Aortography and Peripheral Angiography

NOVITAS-JH-L34865, Magnetic Resonance Angiography (MRA)

NOVITAS-JH-L35092, Diagnostic Abdominal Aortography and Renal Angiography

NOVITAS-JH-L35138, Routine Foot Care

NGS-JK-L33633, Magnetic Resonance Angiography (MRA)

NGS-JK-L33636, Routine Foot Care and Debridement of Nails

NGS-JK-L33627, Non-Invasive Vascular Studies

A56682, Billing and Coding: Diagnostic Abdominal Aortography and Renal Angiography

A52996, Billing and Coding: Routine Foot Care

`I79.8`, Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

I79.8, Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`I79.8`, Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere