Does K31.0 require prior authorization?

No, K31.0 does not require prior authorization (high confidence). Covered without prior authorization.

`K31.0`, Acute dilatation of stomach

ICD-10-CM

No Prior Auth Required

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 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.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.

Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583.
Colon motility (manometric) study, minimum 6 hours continuous recording (CPT 91117) — covered if selection criteria are met.
CPT 78264 Gastric emptying imaging study (eg, solid, liquid, or both) — covered if selection criteria are met.
Use of colonic motility studies (colonic manometry) to guide decision-making for surgery in children with refractory colonic motility / defecatory disorders.
Radionuclide gastric emptying study for the evaluation of gastrointestinal motility disorders, and gastroparesis.
Magnetic resonance enterography to evaluate and monitor Crohn's disease and other small bowel disorders.

FIRST_COAST-L33583, Diagnostic and Therapeutic Esophagogastroduodenoscopy

A57063, Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy

AETNA-CPB-0396, Gastrointestinal Function: Selected Tests

A56389, Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization

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

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