Does I97.640 require prior authorization?

No, I97.640 does not require prior authorization (high confidence). Covered without prior authorization.

`I97.640`, Postprocedural seroma of a circulatory system organ or structure following a cardiac catheterization

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
An interpretation and report must be a complete, separately identifiable written report addressing findings, relevant clinical issues, comparative data (when available), and must be included in the medical record.
The patient's medical record must be legible and clearly document the reasonableness and necessity of the ECG and show that the service was necessary for at least one covered condition in the policy.

An ECG is covered when the result is relevant to the management, diagnosis, or treatment of the patient.
A separate ECG on the same day as a cardiac stress test is payable only when it provides additional clinically necessary information beyond the stress test (e.g., to rule out acute myocardial infarction prior to performing the stress test).
Rhythm ECGs are covered when used to evaluate signs or symptoms suggesting a cardiac rhythm disorder.
Home-based ECG services (including additional payment above the base ECG amount for transportation) are covered when there is a documented medical need to perform the ECG in the patient's home, typically for homebound or bed-confined patients.
A second professional component (PC) interpretation may be paid when a second physician’s substantially greater expertise is necessary and reasonable to clarify a questionable or confusing ECG finding and contributes substantially to diagnosis or treatment.
Non-invasive peripheral arterial vascular studies are covered when the study results will be used in the clinical management of the patient and the medical necessity is documented in the medical record.

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

WPS-J5-L35761, Non-Invasive Peripheral Arterial Vascular Studies

A57593, Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies

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

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

WPS-J8-L35761, Non-Invasive Peripheral Arterial Vascular Studies

A56421, Billing and Coding: CT of the Abdomen and Pelvis

A57326, Billing and Coding: Electrocardiograms