Does K76.4 require prior authorization?

No, K76.4 does not require prior authorization (high confidence). Code is covered without prior authorization.

`K76.4`, Peliosis hepatis

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 article provides billing, coding, and guideline information that complements Local Coverage Determination (LCD) L34544; consult LCD L34544 for clinical eligibility, coverage criteria, and required documentation for hospice services for liver disease.
The ordering physician/nonphysician practitioner must state the clinical indication and medical necessity for the study in the order.
The performing provider must maintain a permanent record of the performed study and interpretation, and must retain a copy of the ordering provider’s order and the test results.

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).
Medically necessary follow‑up non‑invasive abdominal/visceral vascular studies after angioplasty are covered as indicated by the vascular distribution treated.
Non‑invasive abdominal/visceral vascular studies performed in the inpatient hospital (place of service 21) or emergency room (place of service 23) are permitted and are not subject to the routine once‑per‑year outpatient limitation.
Studies are indicated for suspected stenosis of a visceral vein (renal, hepatic, mesenteric, portal, or splenic).
Non-invasive abdominal/visceral vascular studies are medically necessary when signs or symptoms of ischemia or altered blood flow are present.

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

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

WPS-J8-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

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

A56669

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