Does K44.9 require prior authorization?

No, K44.9 does not require prior authorization (high confidence). Code is covered without prior authorization.

`K44.9`, Diaphragmatic hernia without obstruction or gangrene

ICD-10-CM

No Prior Auth Required

Code is 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.
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.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service).

Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583.
OnabotulinumtoxinA (Botox) medically necessary indications (initial approval): Achalasia — Treatment of achalasia when the member has tried and failed or is a poor candidate for conventional therapy such as pneumatic dilation and surgical myotomy.
Botulinum toxin type A has become 1st-line therapy for Frey's syndrome.
Botulinum toxin type A therapy for blepharospasm
Botulinum toxin for chronic low back pain
Botulinum toxin for Raynaud's phenomenon / ischemic digits

FIRST_COAST-L33583, Diagnostic and Therapeutic Esophagogastroduodenoscopy

A57063, Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy

ANTHEM-CG-SURG-92, Paraesophageal Hernia Repair

AETNA-CPB-0113, Botulinum Toxin

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

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