Does K82.8 require prior authorization?

No, K82.8 does not require prior authorization (high confidence). Code is covered without prior authorization.

`K82.8`, Other specified diseases of gallbladder

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.
When a referring or ordering physician is required, the referring/ordering provider's name and NPI must be reported on the claim.
For diagnostic tests, report the test result on the claim if known; if the result is not known at time of billing, report the symptoms that prompted the test.
Diagnosis code(s) on the claim must best describe the patient's condition for which the Vitamin D assay was performed.

Vitamin D assay testing is payable under Medicare Part B when performed in an office (POS 11), independent clinic (POS 49), Federally Qualified Health Center (POS 50), or independent laboratory (POS 81).
Non-physician practitioners (e.g., nurse practitioners, clinical nurse specialists, physician assistants) may certify, order, and establish the plan of care for Vitamin D assay testing as authorized by State law (outpatient settings other than CORFs).
CPT codes covered if selection criteria are met: 78226 (Hepatobiliary system imaging, including gallbladder when present)
ICD-10 codes covered if selection criteria are met: K82.A1 - K82.A2 (Disorders of gallbladder in diseases classified elsewhere)
ICD-10 codes covered if selection criteria are met: K83.1 (Obstruction of bile duct [common])
ICD-10 codes covered if selection criteria are met: K83.4 (Spasm of sphincter of Oddi)

WPS-J5-L34658, Vitamin D Assay Testing

A57484, Billing and Coding: Vitamin D Assay Testing

WPS-J8-L34658, Vitamin D Assay Testing

AETNA-CPB-0266, Cholecystokinin Cholescintigraphy

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

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