Does I82.511 require prior authorization?

No, I82.511 does not require prior authorization (high confidence). Covered without prior authorization.

`I82.511`, Chronic embolism and thrombosis of right femoral vein

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Claims must be submitted with an ICD-10-CM code that represents the reason the procedure was performed, billed to the highest level of specificity, and linked to the appropriate CPT/HCPCS procedure code.
All documentation must be maintained in the patient's medical record, with every page legible, including appropriate patient identification and dates of service, and must include the legible signature of the physician or responsible non-physician practitioner.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Medical record documentation should list the type and duration of conservative (non-stent) treatment attempted, as applicable per the LCD.

Endovenous stenting is covered when used to treat severely symptomatic venous obstructions in accordance with LCD L38231.
Non-invasive vascular studies (duplex scan, physiologic studies, plethysmography, transcranial Doppler) are covered when ordered by the treating or consulting practitioner and medically necessary to evaluate, diagnose, or manage vascular disease.
Initial autogenous access vessel mapping should be billed with HCPCS codes 93985 or 93986 and is covered when medically necessary for surgical planning.
Subsequent autogenous access mapping may be billed with CPT codes 93970 or 93971 when clinically indicated.
Pre-surgical radial artery conduit mapping may be performed and accompanied by vein-mapping when either study shows insufficient conduits for multiple bypass procedures.
Immediate post-operative studies of an access or bypass site are covered if pulses are lost, become equivocal, or the patient develops signs or symptoms of ischemia suggesting need for repeat intervention.

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J15-L40258, MolDX: Genetic Testing for Hereditary Thrombophilia

J15

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

CGS-J18-L40258, MolDX: Genetic Testing for Hereditary Thrombophilia

J18

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