Does K14.0 require prior authorization?

No, K14.0 does not require prior authorization (high confidence). Covered without prior authorization.

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`K14.0`, Glossitis

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

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.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
When billing CPT 84999 for the listed tests, include a note identifying the specific test in the Remarks (Part A) or Narrative (Part B) area of the claim.
All documentation must be maintained in the patient's medical record, be legible, include patient identification (e.g., complete name) and dates of service, and be made available to the contractor upon request.

Key Coverage Criteria

For tests that currently lack specific CPT codes (functional intracellular analysis and total antioxidant function), bill using CPT 84999 and add a note identifying which test was performed in the Remarks area for Part A claims and the Narrative area for Part B claims.
Coverage and reasonable/necessary determinations for assays for vitamins and metabolic function are governed by LCD L34914 and claims must meet that LCD's requirements to be covered.
None listed as covered. The policy states the procedures described below are considered experimental and investigational and therefore not established as effective.
Adjunctive use of wide-area transepithelial sampling with computer-assisted 3-dimensional analysis (WATS-3D) with forceps biopsies (FB) in patients with known or suspected Barrett's esophagus (BE) for detection of intestinal metaplasia (IM), dysplasia (including low-grade dysplasia [LGD] and high-grade dysplasia [HGD]), and esophageal adenocarcinoma (EAC). (Multiple studies described adjunctive increased yield when WATS-3D was added to FB.)
Evaluation of WATS-3D as a standalone substitute for 4-quadrant random forceps biopsies in surveillance of Barrett's esophagus (studied in randomized multicenter trials; no statistically significant difference for HGD/EAC detection as a single modality in at least one enriched BE population).
Use of WATS-3D as an adjunct to forceps biopsies (FB) to increase detection yield of intestinal metaplasia (IM) and dysplasia (including crypt dysplasia (CD), indefinite for dysplasia (IND), low-grade dysplasia (LGD), high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC)) in patients with known or suspected Barrett's esophagus.

5 Active Policies

NOVITAS-JH-L34914, Assays for Vitamins and Metabolic Function

NOVITAS-JL-L34914, Assays for Vitamins and Metabolic Function

A56416, Billing and Coding: Assays for Vitamins and Metabolic Function

ANTHEM-CG-LAB-19, Laboratory Evaluation of Vitamin B12

AETNA-CPB-0686

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K14.0, Glossitis