Does K74.2 require prior authorization?

No, K74.2 does not require prior authorization (high confidence). Code is covered without prior authorization.

`K74.2`, Hepatic fibrosis with hepatic sclerosis

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.
The patient's medical record must include the ordering provider's assessment as it relates to the patient's complaint for that visit.
Medical records must include relevant medical history and results of pertinent tests/procedures that justify the Vitamin D assay.
All services ordered or rendered to Medicare beneficiaries must be signed and dated; include signed and dated office visit records or operative reports in the record.

Vitamin D assay testing billed to Medicare Part A or Part B MAC is covered when ordered by an authorized provider (physician or state-authorized non-physician) and the service is otherwise consistent with local coverage determination L33996.
A valid ICD-10-CM diagnosis code that best describes the patient's condition prompting the Vitamin D assay must be reported on the claim; for diagnostic tests, report the test result if known, otherwise report the presenting symptoms.
When a referring/ordering provider is required, the referring/ordering provider name and NPI must be reported on the claim.
25-hydroxy vitamin D testing (including fractions, if performed) is covered when deemed reasonable and necessary per Local Coverage Determination L33771.
Non‑invasive abdominal/visceral vascular studies are covered when the test results will be used to directly inform or change the patient's clinical management.
A preoperative non‑invasive abdominal/visceral vascular study is covered as reasonable and necessary for patients undergoing bypass surgery (one preoperative scan considered reasonable).

CGS-J15-L33996, Vitamin D Assay Testing

J15

CGS-J18-L33996, Vitamin D Assay Testing

J18

A57591, Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

WPS-J5-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

A57736

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