Does K22.2 require prior authorization?

No, K22.2 does not require prior authorization (high confidence). Code is covered without prior authorization.

`K22.2`, Esophageal obstruction

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing and coding guidance complements Local Coverage Determination L34434; follow LCD L34434 for clinical coverage criteria and required documentation for claims.
All services billed with unlisted procedure codes must include sufficient medical records and supporting documentation to allow development and medical review.
This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
Claims for swallowing studies should include documentation consistent with LCD L33449; this billing guideline is a complement to that LCD and providers should retain medical records supporting the medical necessity of the dysphagia evaluation.

Swallowing studies (videofluoroscopic or radiologic studies described by CPT 70370, 70371, or 74230) performed for evaluation or diagnosis of dysphagia are the intended covered service per this billing guideline and LCD L33449.
Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583.
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.

A57063, Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy

FIRST_COAST-L33583, Diagnostic and Therapeutic Esophagogastroduodenoscopy

NOVITAS-JH-L35350, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)

NOVITAS-JL-L35350, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)

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